The hypertension detection and follow-up program: a progress report.

The NHLBI-supported Hypertension Detection and Follow-Up Program (HDFP) is a community-based program designed to assess the value of early detection and vigorous treatment of persons with high blood pressure of varied severity. HDFP staff members have measured the blood pressures of 158,906 persons in their homes or work places in 14 communities across the United States. Of those persons, 10,940 were found to be hypertensive in a two-state screening process and were enrolled in the Program. Half were referred on a random basis to sources of care in the community, and half were invited to the special Stepped-Care clinics sponsored by the HDFP. These clinics, in a vigorous attempt to normalize blood pressure for all these hypertensive participants, stress intensive follow-up and special attention to achieve compliance with treatment. More than 80% under Stepped Care are continuing on therapy after 2 years, and three-fourths of these have achieved desired normal levels of pressure. The majority of hypertensives found in this Program have less severe elevations of blood pressure, and even among them reductions in blood pressure were substantial because of the vigorous follow-up and special attention to compliance. The HDFP is continuing its efforts to find to what extent sustained treatment of those with elevated blood pressure can reduce mortality or complications due to hypertension.