Comberg H U, Knowles M, Tyroler H A, Heyden S, Hames C G, Sabo D
J Natl Med Assoc. 1988 Dec;80(12):1285-92.
The Evans County, Georgia, cohort of the Hypertension Detection and Follow-up Program (HDFP) was reexamined seven years after termination of the trial in 1979. Of the 510 survivors, 91 percent of the black and 91 percent of the white hypertensive subjects were evaluated by blood pressure (BP) levels, electrocardiograms (ECG), height-weight measurements, and questionnaire. The HDFP had treated a randomly selected half of the patients in an intensive stepped care (SC) program and the other half was referred to usual care (RC). At the beginning of the five-year trial, diastolic blood pressure (DBP) levels were higher in blacks in both SC and RC. At the completion of the trial in 1979, black women had mean DBP levels comparable to whites in both SC and RC, but black men displayed higher levels. During the five years of the trial there were no cases of left ventricular hypertrophy (LVH) in SC in either race. In RC the incidence of LVH was slightly higher in blacks than in whites. During the seven-year post-trial period, the incidence of LVH in blacks rose to 13 percent, more than double that of whites. Medication compliance was reduced in black men during this time, most likely because of removal of the supporting elements of HDFP (frequent medical contacts, free medication).In both races, hypertensive subjects underwent weight changes during the seven years of the post-trial period. Weight loss of 15 lb was associated with normotension. Weight gain of 9 to 10 lb over seven years was associated with hypertensive BP levels.The supportive or detrimental effect of weight loss or weight gain on BP levels was thus reconfirmed in this biracial cohort.
高血压检测与随访项目（HDFP）在佐治亚州伊文斯县的队列研究于1979年试验结束七年后进行了重新检查。在510名幸存者中，91%的黑人高血压患者和91%的白人高血压患者接受了血压（BP）水平、心电图（ECG）、身高体重测量及问卷调查评估。HDFP对随机选取的一半患者采用强化阶梯式护理（SC）方案进行治疗，另一半则接受常规护理（RC）。在为期五年的试验开始时，SC组和RC组中的黑人舒张压（DBP）水平均较高。1979年试验结束时，SC组和RC组中的黑人女性平均DBP水平与白人相当，但黑人男性的DBP水平更高。在试验的五年中，两个种族的SC组均未出现左心室肥厚（LVH）病例。在RC组中，黑人LVH的发病率略高于白人。在试验后的七年期间，黑人LVH的发病率升至13%，是白人的两倍多。在此期间，黑人男性的药物依从性降低，很可能是因为HDFP的支持因素（频繁的医疗接触、免费药物）被取消。在两个种族中，高血压患者在试验后的七年中体重都发生了变化。体重减轻15磅与血压正常相关。七年内体重增加9至10磅与高血压BP水平相关。因此，在这个双种族队列中再次证实了体重减轻或增加对BP水平的支持或有害作用。
