In a randomized , double-blind , practice-based Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial , @,@ hypertensive participants , aged at least @ years , were followed for an average of @ years , for a primary outcome of fatal coronary heart disease or nonfatal myocardial infarction , and secondary outcomes of stroke , heart failure , combined cardiovascular disease , mortality , and renal failure .