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September 19, 1980

Hypertension Detection and Follow-up

JAMA. 1980;244(12):1317-1318. doi:10.1001/jama.1980.03310120011005

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To the Editor.—  Regarding the preliminary results on mortality of the HDFP, future application of the results of this study could have a major impact on the health of the American people and the cost of medical care in this country. Therefore, it is important to take a critical look at the study before altering therapeutic practice based on its results.We have the following reservations about the study:

  1. The HDFP enrolled people 25% of whom were already undergoing antihypertensive treatment at the time of screening. No attempt was made to obtain an untreated screening BP. Thus, the HDFP "mild hypertension" group may include persons who actually have moderate or severe untreated hypertension.

  2. Because of the HDFP study design, the beneficial effect of antihypertensive drug therapy cannot readily be separated from the HDFP clinic effect, ie, the additional effect of the patient receiving special attention at HDFP study