In the second phase the research was continued and extended in three areas: 1) Population studies on risk factors. At the start of the study in 1991, it was not clear that adequate procedures were available to allow standardization of mean blood pressure across sites, especially since differences between some sites might be as little as 2 mmHg. Experience since that time suggested that it would be feasible to collect definitive data on this question. In-depth studies were carried out at one of the African sites to investigate the earliest stages of hypertension risk for a population. Investigators in Jamaica and the United Kingdom joined the collaborative group to examine the effect of migration from the Caribbean to the United Kingdom. 2) Prospective study of blood pressure and mortality. It was well known that hypertension accounted for much of the excess mortality among United States Blacks. It was less well recognized, however, that death rates among Blacks in the United States were higher than reported in the Caribbean or Africa. Hypertension was likely to account for that differential. A follow-up study in each region estimated the relative and attributable risk from hypertension. 3) Heredity/Genetics. The populations in this study shared a common ancestral origin in West Africa. Family studies were undertaken to determine the heritability of blood pressure/hypertension within and between sites. In addition, pilot studies on genetic distance and candidate genes for hypertension were conducted.