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December 7, 1979JAMA

Five-year findings of the hypertension detection and follow-up program. I. Reduction in mortality of persons with high blood pressure, including mild hypertension. Hypertension Detection and Follow-up Program Cooperative Group

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Why the study?

Does a systematic antihypertensive treatment program reduce five-year mortality compared to referral to community medical therapy in persons with high blood pressure?

Population

10,940 persons with high blood pressure, aged 30 to 69 years, recruited by population-based screening in 14…

Comparison

Systematic antihypertensive treatment program vs Referral to community medical therapy

Design

RCT, Randomly assigned to SC or RC groups within each center and by entry…

Follow-up

five years

Discussion

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Implication

Supports systematic stepped-care hypertension programs; confirms all-cause mortality benefit versus community referral in RCT.

Key Points

  • The study aims to evaluate the impact of systematic antihypertensive treatment on mortality rates among individuals with high blood pressure.
  • Community-based randomized controlled trial with 10,940 participants aged 30 to 69.
  • Participants were assigned to either Stepped Care (SC) or Referred Care (RC) groups based on diastolic blood pressure (DBP).
  • Follow-up over five years assessing blood pressure control and mortality rates.
  • Five-year mortality was 17% lower in the SC group (6.4 per 100) compared to the RC group (7.7 per 100, P<.01).
  • For those with entry DBP of 90 to 104 mm Hg, SC group had 20% lower mortality (5.9 vs 7.4 per 100, P<.01).
  • More than 50% of SC participants achieved blood pressure within the normotensive range.

Structured PICO

Does a systematic antihypertensive treatment program reduce five-year mortality compared to referral to community medical therapy in persons with high blood pressure?

P
Population
10,940 persons with high blood pressure (BP), aged 30 to 69 years, recruited by population-based screening in 14 communities throughout the United States. Entry DBP 90+ mm Hg.
I
Intervention
Systematic antihypertensive treatment program (Stepped Care [SC])
C
Comparator
Referral to community medical therapy (Referred Care [RC])
O
Outcome
Five-year mortality from all causeshard clinical

Systematic effective management of hypertension significantly reduces five-year all-cause mortality compared to standard community referral, including in patients with mild hypertension.

Cite This Study

A 1979 study studied this question.

synapsesocial.com/papers/6a19c6d5443d3ecd7cdeff6dhttps://doi.org/10.1001/jama.242.23.2562

Topics

Hypertension management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Five-Year Findings of the Hypertension Detection and Follow-up Program1979 · 1,259 citations
  2. 2The hypertension detection and follow-up program: 17 years on1997 · 16 citations
  3. 3Five-year findings of the hypertension detection and follow-up program. III. Reduction in stroke incidence among persons with high blood pressure. Hypertension Detection and Follow-up Program Cooperative Group1982 · 78 citations
  4. 4Persistence of Reduction in Blood Pressure and Mortality of Participants in the Hypertension Detection and Follow-up Program1988 · 103 citations
  5. 5Five-year findings of the hypertension detection and follow-up program. II. Mortality by race-sex and age. Hypertension Detection and Follow-up Program Cooperative Group1979 · 89 citations