Interpretation of the Hypertension Detection and Follow-up Program
Five months ago, the Hypertension Detection and Follow-up Program (HDFP) reported findings for its primary design end point, all cause mortality (1, 2). This community-based randomized trial screened 158,906 individuals aged 30–69 in 14 communities nationwide. Attempts were made to enroll all individuals with blood pressure elevations maintained through two screenings, at home and in the clinic, and high participation rates were achieved. Because very few individuals were to be excluded, it was ethically unfeasible to use placebos, thereby blocking treatment for persons with very high blood pressures. Participants were randomly assigned to stepped care or referred care groups, and the randomization was effective in equating the groups. Referred care participants received a full base-line examination and were then sent to their usual source of care in the community, while participating in annual follow-up examinations under study auspices.
KeywordsHigh Blood Pressure Blood Pressure Elevation Mortality Reduction Mild Hypertension Goal Blood Pressure
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