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17 Years On

Lawrence E. Ramsay, MB ChB, FRCP

JAMA. 1997;277(2):167-170.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

The Hypertension Detection and Follow-up Program (HDFP)¹ was a remarkable feat of clinical investigation that tackled an important question. The study design was a gamble—a $60 million gamble²—that paid off. A respectable difference in diastolic blood pressure (DBP) between stepped care (SC) and referred care (RC) groups was crucial for this massive undertaking to succeed. In fact, the net DBP difference was "only" 5 to 6 mm Hg over the 5 years, but we now know that this is identical to the net DBP difference in all conventionally designed controlled trials of antihypertensive drugs.³ Allcause mortality, the principal end point, was reduced in all SC subjects by 17% (P<.01), and by 20% (P<.01) in those with initial DBP of 90 to 104 mm Hg. Treatment of 66 subjects with DBP 90 to 104 mm Hg for 5 years prevented 1 death, a return that compares favorably . . . [Full Text PDF of this Article]

Author Affiliations
From the Section of Clinical Pharmacology and Therapeutics, Department of Medicine and Pharmacology, Royal Hallamshire Hospital, Sheffield, England.

Footnotes
A commentary on Hypertension Detection and Follow-up Program Cooperative Group. Five-year findings of the Hypertension Detection and Follow-up Program, I: reduction in mortality of persons with high blood pressure, including mild hypertension. JAMA. 1979;242:2562-2571.

Reprints: Professor L. E. Ramsay, Section of Clinical Pharmacology and Therapeutics, Department of Medicine and Pharmacology, L Floor, Royal Hallamshire-Hospital, Glossop Road, Sheffield S10 2JF, England.

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