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 495 survivors, 91% of the hypertensives were evaluated by diastolic blood pressure levels, electrocardiograms, weight measurements, and questionnaire. In the HDFP 50% of the randomly selected patients had been treated in an intensive stepped care (SC) program and the other half had been referred to usual care (RC). After five years diastolic blood pressure levels were higher in RC than in SC; after twelve years blood pressure levels were still higher in RC than in SC in spite of greater use of blood pressure medication. During the five years of the trial there was no case of left ventricular hypertrophy (LVH) in SC. After twelve years the incidence of hypertrophy was lower in SC than in RC. The most frequently used blood pressure medications (chlortalidone, reserpine and methyldopa) did not influence quality of life. During the seven years of the posttrial period the hypertensives underwent weight changes. Weight loss of 15 lb was associated with normotension, even without medication; weight gain of 9 to 10 lb over seven years was associated with hypertensive blood pressure levels, even in formerly normotensives.