5-YEAR FINDINGS OF THE HYPERTENSION DETECTION AND FOLLOW-UP PROGRAM .1. REDUCTION IN MORTALITY OF PERSONS WITH HIGH BLOOD-PRESSURE, INCLUDING MILD HYPERTENSION (REPRINTED FROM JAMA, VOL 242, PG 2562-2571, 1979)
Ap. Shapiro et al., 5-YEAR FINDINGS OF THE HYPERTENSION DETECTION AND FOLLOW-UP PROGRAM .1. REDUCTION IN MORTALITY OF PERSONS WITH HIGH BLOOD-PRESSURE, INCLUDING MILD HYPERTENSION (REPRINTED FROM JAMA, VOL 242, PG 2562-2571, 1979), JAMA, the journal of the American Medical Association, 277(2), 1997, pp. 157-166
The Hypertension Detection and Follow-up Program (HDFP), in a communit
y-based, randomized controlled trial involving 10,940 persons with hig
h blood pressure (BP), compared the effects on five-year mortality of
a systematic antihypertensive treatment program (Stepped Care [SC]) an
d referral to community medical therapy (Referred [RC]). Participants,
recruited by population-based screening of 158,906 people aged 30 to
69 years in 14 communities throughout the United States, were randomly
assigned to SC or RC groups within each center and by entry diastolic
blood pressure (DBP) (90 to 104, 105 to 114, and 115+ mm Hg). Over th
e five years of the study, more than two thirds of the SC participants
continued to receive medication, and more than 50% achieved BP levels
within the normotensive range, at or below the HDFP goal for DBP. Con
trol of BP was consistently better for the SC than for the RC group. F
ive-year mortality from all causes was 17% lower for the SC group comp
ared to the RC group (6.4 vs 7.7 per 100, P<.01) and 20% lower for the
SC subgroup with entry DBP of 90 to 104 mm Hg compared to the corresp
onding RC subgroup (5.9 vs 7.4 per 100, P<.01). These findings of the
HDFP indicate that the systematic effective management of hypertension
has a great potential for reducing mortality for the large numbers of
people with high BP in the population, including those with ''mild''
hypertension.