2 aged 60 years or older [12]. Another mortality study of adults aged 30–74 years at the time of the NHANES II examination showed that almost 90% of individuals with prehypertension had at least one other cardiovascular risk factor [13]. Many studies demonstrated that the prehypertensive group had higher levels of blood glucose, total cholesterol, low- density lipoprotein cholesterol, and triglycerides, higher body mass index, and lower levels of high-density lipoprotein cholesterol than the normotensive group [14, 15]. Obesity, abnormalities of glucose metabolism, and insulin resistance were the major factors associated with prehypertension and hypertension [16]. BMI was a strong predictor of prehypertension. The Jichi Medical School Cohort Study which enrolled 4,706 males and 7,342 females of Japanese general population suggested that body mass index (BMI) of more than 23.0 kg/m2 was the strongest determinant of prehypertension [9]. Prehypertension was more prevalent in diabetic than nondiabetic participants. Compared with nondiabetic participants with normal blood pressure, the hazard ratios of cardiovascular disease were higher for those with both prehypertension and diabetes than for those with prehypertension alone [17]. Other nontraditional cardiovascular risk factors had also been relevant to the development of prehypertension. The prevalence of metabolic syndrome in the prehypertension group was higher than in the normal BP group. Larger waist circumference and body mass index, higher levels of triglycerides, fasting blood glucose, uric acid and ferritin, and lower levels of high-density lipoprotein-cholesterol were more common in subjects with prehypertension than in those with normal BP [18]. Compared to normoten- sives, prehypertension had higher C-reactive protein, tumor necrosis factor-alpha, amyloid-a, homocysteine levels, and higher white blood cell counts after correcting for multiple comparisons and adjusting for age, body mass index, blood lipids, glucose, food groups consumed, and other potential confounders [19]. It was also found that the prevalence of microalbuminuria in the prehypertension group was higher than in the normal BP group [18]. The nationally represen- tative sample of US adults among 5,827 participants without cardiovascular disease (CVD) and hypertension concluded that prehypertension was associated with higher serum gamma-glutamyltransferase (GGT) levels [20]. In recent years, people pay more attention to whether prehypertension causes change of myocardial structure and function. After adjusting for intergroup diﬀerences in age, diabetes, body mass index, smoking, study center, and plasma creatinine, and mean values for left ventricular (LV) measurements were found to be signiﬁcantly increased in both the prehyper- tensive and hypertensive groups compared with the normal blood pressure group. LV systolic and diastolic function diﬀered signiﬁcantly in the hypertensive groups, but not in the prehypertensive participants, compared with the normal blood pressure group [21]. It suggested that the LV structure had been changed during prehypertension period; however, the LV systolic and diastolic function had not been impacted by the change. International Journal of Hypertension 2.3. Cardiovascular Disease and Prehypertension. Individu- als with prehypertensive levels of blood pressure had an increased risk of developing cardiovascular disease relative to those with optimal levels. The association was pronounced among individuals with diabetes mellitus, and among those with high BMI [22]. It was also found that prehypertension was associated with an increased risk for cardiovascular disease, including myocardial infarction (MI) and coronary artery disease (CAD), but no stroke, with a mean follow- up period of 10 years [23]. The Jichi Medical School Cohort Studys of Japan discovered that prehypertension was associated with a 45% higher risk of cardiovascular events than normal blood pressure after adjusting for traditional cardiovascular risk factors. Prehypertension was associated with an increased 10-year risk of cardiovascular disease; the risk of cardiovascular events with prehypertension during the second 5-year period was elevated in the nonelderly subgroup (<65 years) [9]. A meta-analysis that included approximately 1 million individuals from 61 long-term epidemiological studies demonstrated that mortality from ischemic heart disease and stroke in individuals aged 40– 89 years increased in a log-linear relationship together with increases in both systolic/diastolic blood pressure. For each 20 mmHg increase in systolic blood pressure or 10 mmHg increase in diastolic blood pressure over 115/75 mmHg, there was a twofold increase in mortality associated with coronary artery disease and stroke [24]. Longitudinal data from the Framingham Heart study indicated that individuals formerly classiﬁed as having “normal” and “high-normal” blood pressure (120–139/80–89 mmHg) were at increased risk of developing full-blown hypertension and cardiovascular disease later in life than those who had an optimal blood pressure (<120/80 mmHg) [25]. The study among 68,438 urban Chinese women aged 40–70 years during an average of 5 years of followup showed that hypertension was associated with high stroke mortality [26]. 3. Treatment 3.1. Strategy of Treatment. The relationship between prehy- pertension and cardiovascular disease aroused widespread concern, and it became an important subject to prevent and intervene. JNC-7 suggested the individuals of prehy- pertension adopted a healthy lifestyle in order to lower blood pressure and prevent progression to hypertension, with associated reductions in target organ damage and cardiovascular events. 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension emphasized that cardiovascular complications of patients should immediately take drug therapy to reduce the risk of cardiovascular events even in the scope of prehypertensive [27]. 3.2. Nonpharmacological Treatments. Prehypertensive blood pressure levels identify individuals with elevated risk of developing hypertension. Prehypertensive patients are not the usual candidates for antihypertensive drug therapy, and prehypertensive individuals should primarily be advised to modify their lifestyle to lower their blood pressure to normal