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. 2008 Nov-Dec;2(6):448-54.
doi: 10.1016/j.jash.2008.05.007.

Thirty-year Survival for Black and White Hypertensive Individuals in the Evans County Heart Study and the Hypertension Detection and Follow-up Program

Daniel T Lackland  1 , Brent M Egan, William K Mountford, Andrea D Boan, Denis A Evans, Gregory Gilbert, Daniel L McGee
Affiliations

Thirty-year Survival for Black and White Hypertensive Individuals in the Evans County Heart Study and the Hypertension Detection and Follow-up Program

Daniel T Lackland et al. J Am Soc Hypertens. 2008 Nov-Dec.

Abstract

The Evans County Heart Study (ECHS), initiated in 1960, was one of the first major studies to document cardiovascular disease (CVD) risks for African Americans and Caucasians with elevated blood pressures. In the early 1970's, the Hypertension Detection and Follow-up Program (HDFP), with a site in Georgia (HDFP-GA) was one of the first major studies to demonstrate that treating hypertension with stepped care (SC), versus referred care (RC), has better short-term outcomes. With this background, study objectives were to evaluate 30-year survival and cardiovascular outcomes of the HDFP-GA and to compare outcomes of these patients with 1619 hypertensive individuals (30-69 years of age) from the ECHS. HDFP-GA patients included 688 individuals (black [n=267]; white [n=421]) randomized to RC (n=341) and SC (n=347). The ECHS was comprised of 733 black and 886 white hypertensives. All-cause mortality and CVD mortality were assessed in the HDFP-GA and compared to the ECHS hypertensives. After 30-years of follow-up, 65.7% of the HDFP-GA cohort had died compared with a similar 65.8% of the ECHS hypertensives. However, CVD mortality rates, while similar for the SC and RC arms, were lower than in the HDFP-GA total study group than the hypertensive participants of ECHS (32.6% vs. 40.3% p<.001). CVD survival rates for both SC and RC HDFP-GA arms were significantly better than population-based hypertensive individuals in the ECHS, with consistent benefits in all four race-sex groups. These results identify the importance of long-term follow-up of individuals in hypertension studies and trials that include CVD outcomes.

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Figures

Figure 1
Figure 1
Survival curves for all-cause mortality for Hypertension Detection and Follow-up Program-Georgia Site (HDFP) and Evans County Heart Study hypertensive cohort (ECHS)
Figure 2
Figure 2
Survival curves for cardiovascular disease for Hypertension Detection and Follow-up Program-Georgia Site (HDFP) and Evans County Heart Study hypertensive cohort (ECHS)
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References

    1. Tyroler HA, Heyden S, Bartel A, Cassel J, Cornoni JC, Hames CG, et al. Blood pressure and Cholesterol as Coronary Heart Disease risk Factors. Archives of Internal Medicine. 1971;128:907–914. - PubMed
    1. Lackland DT, Keil JE, Gazes PC, Hames CG, Tyroler HA. Outcomes of black and white hypertensive individuals after 30 years of follow-up. Clinical and Experimental Hypertension. 1995;17:1091–1105. - PubMed
    1. Anonymous. Effects of treatment on morbidity in hypertension. II. Results in patients with diastolic blood pressure averaging 90 through 114 mm Hg. JAMA. 1970;213:1143–52. - PubMed
    1. Epstein FH, Ostrander LD, jr, Johnson BC, Payne MW, Hayner NS, Keller JB, et al. Epidemiological studies of cardiovascular disease in a total community – Tecumseh, Michigan. Annals of Internal Medicine. 1965;62:1170–87. - PubMed
    1. Stamler J, Stamler R, Rhomberg P, Dyer A, Berkson DM, Reedus W, et al. Multivariate analysis of the relationship of six variables to blood pressure: findings from Chicago community surveys, 1965-1971. Journal of Chronic Disease. 1975;28:499–525. - PubMed

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