Effect of stepped care treatment on the incidence of myocardial infarction and angina pectoris. 5-Year findings of the hypertension detection and follow-up program.

Information on indices of coronary heart disease (CHD) and myocardial infarction (MI) (angina pectoris by Rose Questionnaire, MI by Rose Questionnaire, history, and electrocardiogram) was obtained in the Hypertension Detection and Follow-Up Program (U.S. National Institutes of Health) at baseline, Year 2, and Year 5 of follow-up. The presence of any of these findings at baseline markedly increased all-cause mortality during the 5 years of observation. In individuals with negative findings at baseline, the 5-year incidence of MI and angina pectoris by these indices was less in the Stepped Care than Referred Care cohort. These results are compatible with the conclusion that antihypertensive therapy reduces the incidence of symptomatic CHD.