Five-Year Findings of the Hypertension Detection and Follow-up Program: I. Reduction in Mortality of Persons With High Blood Pressure, Including Mild Hypertension
Abstract
The Hypertension Detection and Follow-up Program (HDFP), in a community-based, randomized controlled trial involving 10,940 persons with high blood pressure (BP), compared the effects on five-year mortality of a systematic antihypertensive treatment program (Stepped Care [SC]) and referral to community medical therapy (Referred Care [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 the 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. Control of BP was consistently better for the SC than for the RC group. Five-year mortality from all causes was 17% lower for the SC group compared 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 corresponding 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. (JAMA242:2562-2571, 1979)
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In recent United States and European guidelines, new and lower OBP targets were proposed based on evidence from observational studies, few specifically designed interventional trials (in particular SPRINT), and recent meta-analyses.
“In recent United States and European guidelines, new and lower OBP targets were proposed based on the evidence from observational studies, from few specifically designed interventional trials, in particular SPRINT [152], and from recent meta-analyses [153,154]”
Cited by
Sorted by citations
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Hypertension · doi:10.1161/hyp.0000000000000065 · Cited by 7,391 · see citing works
Dahlöf, B., Sever, P. S., Poulter, N. R., Wedel, H., Beevers, D. G., Caulfield, M., Collins, R., Kjeldsen, S. E., Kristinsson, A., McInnes, G. T., et al. (2005) · The Lancet · doi:10.1016/s0140-6736(05)67185-1 · Cited by 2,909 · see citing works
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., DePalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., et al. (2018) · Circulation · doi:10.1161/cir.0000000000000596 · Cited by 1,127 · see citing works
Fihn, S. D., Gardin, J. M., Abrams, J., Berra, K., Blankenship, J. C., Dallas, A. P., Douglas, P. S., Foody, J. M., Gerber, T. C., Hinderliter, A. L., et al. (2012) · Circulation · doi:10.1161/cir.0b013e318277d6a0 · Cited by 845 · see citing works
Lackland, D. T., Roccella, E. J., Deutsch, A. F., Fornage, M., George, M. G., Howard, G., Kissela, B. M., Kittner, S. J., Lichtman, J. H., Lisabeth, L. D., et al. (2014) · Stroke · doi:10.1161/01.str.0000437068.30550.cf · Cited by 815 · see citing works
Multiple behavioral risk factor interventions in primary care
Goldstein, M. G., Whitlock, E. P., & DePue, J. (2004) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2004.04.023 · Cited by 467 · see citing works
Ernst, M. E., Carter, B. L., Goerdt, C. J., Steffensmeier, J. J. G., Phillips, B. B., Zimmerman, M. B., & Bergus, G. R. (2006) · Hypertension · doi:10.1161/01.hyp.0000203309.07140.d3 · Cited by 433 · see citing works
Position of the American Dietetic Association and Dietitians of Canada: Vegetarian diets
(2003) · Journal of the American Dietetic Association · doi:10.1053/jada.2003.50142 · Cited by 414 · see citing works
Thomopoulos, C., Parati, G., & Zanchetti, A. (2014) · Journal of Hypertension · doi:10.1097/hjh.0000000000000378 · Cited by 388 · see citing works
Thomopoulos, C., Parati, G., & Zanchetti, A. (2016) · Journal of Hypertension · doi:10.1097/hjh.0000000000000881 · Cited by 298 · see citing works
Parati, G., Stergiou, G. S., Bilo, G., Kollias, A., Pengo, M., Ochoa, J. E., Agarwal, R., Asayama, K., Asmar, R., Burnier, M., et al. (2021) · Journal of Hypertension · doi:10.1097/hjh.0000000000002922 · Cited by 178 · see citing works
Winkleby, M. A., Feldman, H. A., & Murray, D. M. (1997) · Journal of Clinical Epidemiology · doi:10.1016/s0895-4356(97)00020-6 · Cited by 122 · see citing works
Considering Usual Medical Care in Clinical Trial Design
Dawson, L., Zarin, D. A., Emanuel, E. J., Friedman, L. M., Chaudhari, B., & Goodman, S. N. (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000111 · Cited by 93 · see citing works
Timeline of History of Hypertension Treatment
Saklayen, M. G., & Deshpande, N. V. (2016) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2016.00003 · Cited by 96 · see citing works
The effects of caffeine on ambulatory blood pressure, heart rate, and mood in coffee drinkers
Green, P. J., & Suls, J. (1996) · Journal of Behavioral Medicine · doi:10.1007/bf01857602 · Cited by 84 · see citing works
Intensifying Therapy for Hypertension Despite Suboptimal Adherence
Rose, A. J., Berlowitz, D. R., Manze, M., Orner, M. B., & Kressin, N. R. (2009) · Hypertension · doi:10.1161/hypertensionaha.109.133389 · Cited by 47 · see citing works
Gueyffier, F., Boissel, J.-P., Pocock, S., Boutitie, F., Coope, J., Cutler, J., Ekbom, T., Fagard, R., Friedman, L., Kerlikowske, K., et al. (1999) · Circulation · doi:10.1161/01.cir.100.18.e88 · Cited by 46 · see citing works
Piatt, G. A., Rodgers, E. A., Xue, L., & Zgibor, J. C. (2018) · The Diabetes Educator · doi:10.1177/0145721718777855 · Cited by 29 · see citing works
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1979-12-07
- Volume
- 242
- Issue
- 23
- Pages
- 2562
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W4255974390
- Cited by
- 1,246
- References
- 0
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 3 · 2023: 4 · 2022: 7 · 2021: 4 · 2020: 5 · 2019: 11 · 2018: 20 · 2017: 18 · 2016: 10 · 2015: 16 · 2014: 15 · 2013: 7 · 2012: 23
- FWCI
- 50.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Keywords
- hypertension, stepped care, antihypertensive therapy, blood pressure control, mortality reduction, community-based screening, mild hypertension, diastolic blood pressure, primary prevention
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
