Circulation, Vol 70, 996-1003, Copyright © 1984 by American Heart Association
The Hypertension Detection and Follow-up Program (HDFP) reported a
significant reduction in 5 year mortality from all causes in its
intensively treated stepped care group compared with its referred care
group (p less than .01). In stratum I (mean baseline diastolic blood
pressure 90 to 104 mm Hg) mortality in the stepped care group was 20.3%
lower than that in the referred care group (p less than .01). For persons
in this stratum not on antihypertensive drugs at baseline and free of major
target organ damage, mortality in the stepped care group was 28.6% lower
than that in the referred care group (p less than .01). Publication of the
results of Multiple Risk Factor Intervention Trail (MRFIT), indicating
possibly increased mortality in special intervention hypertensive
participants with resting electrocardiographic (ECG) abnormalities,
prompted further analyses of the HDFP data to determine whether stepped
care drug treatment in stratum I patients with resting ECG abnormalities
was associated with a similar outcome. Of the 7825 HDFP participants in
stratum I, 5173 met MRFIT eligibility criteria and qualified as a subgroup
comparable to the MRFIT "mild" hypertensives, 1963 with and 3210 without
evidence of resting ECG abnormalities at baseline. In the subgroup without
resting ECG abnormalities, mortality rates for coronary heart disease,
major cardiovascular diseases, and for all causes were consistently lower
in the stepped care group than in the referred care group. This finding was
consistent with the MRFIT results.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
The effect of antihypertensive drug treatment on mortality in the presence of resting electrocardiographic abnormalities at baseline: the HDFP experience. The Hypertension Detection and Follow-up Program Cooperative Research Group
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