The purpose of this program is to conduct a practice-based, randomized clinical trial of antihypertensive pharmacologic treatment and, in a specific subset, lipid-lowering, in 40,000 high-risk hypertensive patients including at least 55% African-Americans. The purpose of the antihypertensive trial is to determine whether the combined incidence of fatal coronary heart disease (CHD)) and non-fatal myocardial infarction differs between diuretic treatment and three alternative antihypertensive pharmacologic treatments: a calcium antagonist, an angiotensin converting enzyme (ACL) inhibitor, and an alpha adrenergic blocker. The purpose of the cholesterol-lowering component is to determine whether lowering serum cholesterol in moderately hypercholesterolemic men and women aged 60 years and older with a 3-hydroxymethylgiutaryl coenzyme A (HMG CoA) reductase inhibitor will reduce the combined incidence of fatal CHD and non-fatal myocardial infarction. Inclusion of the cholesterol- lowering component is contingent on obtaining an HMG-CoA reductase inhibitor, which has not been finalized at this time. Approval to proceed with the lipid-lowering trial will not be granted until the availability of this agent has been secured. Rather than using independently funded clinics, patients will be recruited through office-based practices and hypertension clinics which will be reimbursed by the Clinical Trials Center (CTC) on a per-patient basis. This contract is for the Clinical Trials Center. Some of the functions of the Clinical Trials Center include coordinating all data collection, storage of data, analysis activities related to the study, and recruiting and training (along with the NHLBI) appropriate clinical sites and core laboratories required to conduct the study.
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