Abstract: The present invention relates to ?-guanidinopropionic acid for the prevention and/or treatment of hypertension associated with high baseline creatine kinase levels, not necessarily associated with hyperglycemia, impaired glucose tolerance, hyperinsulinemia, insulin insensitivity, hyperamilinemia, excess adiposity or hyperlipidemia, comprising administering to a subject in need thereof a therapeutically effective dosage of a pharmaceutical composition comprising ?-guanidinopropionic acid, or a pharmaceutically acceptable salt or derivative thereof, and a pharmaceutically acceptable carrier.