AIM:To evaluate efficacy and tolerability of the combination valsartan plus hydrochlorothiazide(160 mg and 25 mg daily,respectively) in young-middle aged males with high-normal blood pressure(BP) or firstdegree arterial hypertension with evidence of target organ damage.METHODS:Twenty males with high-normal BP or first-degree hypertension associated with left ventricular concentric remodeling and/or increased aortic stiffness were enrolled.BP at rest and during exercise,and echocardiographic parameters of the left ventricle(LV),were evaluated at baseline and after 3 mo of treatment.The effects of treatment on aortic stiffness,metabolic parameters,renal and erectile function were also assessed.RESULTS:BP was significantly reduced by treatment both at rest(P < 0.001) and during exercise(P < 0.001),and 85% of patients achieved BP normalization(< 130/85 mmHg).Doppler echocardiography showed a significant reduction of LV mass(P < 0.005).LV hypertrophy was identified in 70% of subjects at baseline and in 5% after 3 mo of treatment.The ratio of early(E) to late(A) trans-mitral diastolic flow velocity increased,(P < 0.05),the relative wall thickness decreased(P < 0.05) and the left ventricular relaxation time shortened(P < 0.005).The left atrial diameter(P < 0.05) and the aortic diameter(P < 0.05) and stiffness(P < 0.005) also decreased.CONCLUSION:The full-dose combination of valsartan plus hydrochlorothiazide produced optimal BP control with regression of target organ damage,already after 3 mo,without relevant side effects. AIM: To evaluate efficacy and tolerability of the combination valsartan plus hydrochlorothiazide (160 mg and 25 mg daily, respectively) in young-middle aged males with high-normal blood pressure (BP) or firstdegree arterial hypertension with evidence of target organ damage. METHODS : Twenty males with high-normal BP or first-degree hypertension associated with left ventricular concentric remodeling and / or increased aortic stiffness were enrolled. BP at rest and during exercise, and echocardiographic parameters of the left ventricle (LV), were evaluated at baseline and after 3 mo of treatment. The effects of treatment on aortic stiffness, metabolic parameters, renal and erectile function were also assessed .RESULTS: BP was significantly reduced by treatment both at rest (P <0.001) and during exercise (P <0.001) , and 85% of patients achieved BP normalization (<130/85 mmHg). Doppler echocardiography showed a significant reduction of LV mass (P <0.005). LV hypertrophy was identified in 70% of subjects at bas eline and in 5% after 3 mo of treatment.The ratio of early (E) to late (A) trans-mitral diastolic flow velocity increased, (P <0.05), the relative wall thickness decreased The left atrial diameter (P <0.05) and the aortic diameter (P <0.05) and stiffness (P <0.005) also decreased. CONCLUSION: The full-dose combination of valsartan plus hydrochlorothiazide produced optimal BP control with regression of target organ damage, already after 3 mo, without relevant side effects.