Hypertension affects about one in four adult Americans and the single most common medical condition for clinic visits to primary care physicians. Hypertension is a major risk factor for CHD and the primary risk factor for stroke. The actual detection, treatment and control of hypertension in the U.S. is disappointing. Only about two thirds of hypertensives are aware of their condition, only half are treated, and only about 20 percent are adequately controlled using a conservative definition (less than 140/90 mm Hg). This analysis grant will provide support for new analyses and reports of the Treatment of Mild Hypertension Study (TOMHS), a double-blind, randomized, placebo-controlled study of Stage I (mild) diastolic hypertensives. The study randomized 902 men and women ages 45-69 years to either placebo or one of five active drug therapies. All participants received lifestyle intervention aimed at weight loss, sodium and alcohol reduction, and increase in physical activity. Participants were followed for a minimum of four ears with annual visit attendance exceeding 92 percent. Sixty percent of participants were men and 20 percent were African-American. New analyses of the TOMHS data would yield valuable information. Data will be analyzed to support the development of 8 papers representing new questions and specific subgroup analyses from this study. These papers will investigate the following topics: 1] side effects observed related to study drug and placebo; 2] the effects of the physical activity component on blood pressure and other study outcomes; 3] the effect of taking antihypertensive medications prior to the start of the study versus beginning them as a result of the trial on blood pressure control, functional status, and sexual functioning; 4] evaluate the ability of ECG and echocardiography to predict future cardiovascular events; 5] evaluate changes in ECG findings related to systolic performance while being treated for hypertension; 6] evaluation of the relationship of anthropometric measurements and blood pressure; 7] evaluate the effects of non-steroidal anti-inflammatory medications on blood pressure response; and 8] evaluate study outcomes in patients 60 years of age or older at baseline versus younger participants.
