Abstract
Five-year morbidity and mortality in the Hypertension Detection and Follow-Up Program (HDFP) were stratified by age groups at entry to the study and by Stepped Care (SC) and Referred Care (RC) treatment groups. Although the incidence of stroke increased with age in both treatment groups, the greatest reduction in strokes for SC versus RC occurred in the older age groups: 44.3% for ages 60-69, 33.0% for ages 50-59, and 24.6% for ages 30-49. Conversely, the 30-49-year SC group showed a greater reduction of myocardial infarction than their RC counterparts, with only marginal benefit in the older SC patients. There was a lower rate of left ventricular hypertrophy (LVH) or cardiomegaly and a higher rate of reversal in those who had LVH or cardiomegaly at baseline in all SC age groups versus RC. HDFP patients 50 years and older at entry in the SC group had a substantial reduction in cardiovascular morbidity and mortality as compared with age-matched RC patients. It is likely that these benefits were the result of successful lowering of blood pressure.
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