Correlates of attendance and compliance in the hypertension detection and follow-up program

The Hypertension Detection and Follow-Up Program (HDFP) screened 159,000 individuals aged 30-69 years in 14 communities. Using a two-stage process, 10,940 hypertensives were randomized into two treatment groups. The first group was referred to community sources for care (RC), and the second received free Stepped Care (SC) treatment with extensive efforts to reduce the barriers to care. One year after enrollment, attendance showed 85% of SC participants active (white males 88%, white females 84%, black males 83%, and black females 84%). One year attendance rates ranged from a low of 84% for those with baseline DBP 90-104 mm Hg to a high of 90% for those with baseline DBP greater than or equal to 115 mm Hg. There was no apparent association with age, however, attendance exhibited a positive relationship with education, ranging from 83% for those completing less than high school to 94% for those with degrees beyond college. Life tables analyses demonstrated that race, sex, and blood pressure level compliance differences manifest themselves at the early stages of enrollment with little variation among participants once in the program. Pill counts correlated with percent with controlled blood pressure as well as serum potassium and calcium levels. Educational level was also a major predictor of drug adherence ranging from 74.7% to 89.7% (from under 7th grade to above college) having taken greater than or equal to 80% of their pills.