Prehypertension is a part of the continuum from normotension to hypertension it is a part of a dynamic process of stiffening and aging of the arteries and of the heart with its consequences. Patients in the prehypertensive range will become finally hypertensive. Diseased arteries will not only participate in propagation of end organ damage but will enhance the progression of additional damage in the arteries and the heart. Understanding the risk of borderline conditions in the metabolic syndrome will enable us to understand the nature of end organ damage and will create a possibility of better prevention of this continuous process.