Thirty-two patients who were being treated with drugs for essential hypertension were started on a dietary regimen comprising high-fibre, low-fat and low-sodium composition. The results are reported of 19 patients who attended after 3 months and for a long-term mean follow-up period of 3.9 years. A significant reduction in systolic (P less than 0.01) and diastolic blood pressure (P less than 0.001) was observed at 3 months and again after 3.9 years (P less than 0.05 and less than 0.001 respectively). This was accompanied by significant weight loss at 3.9 years (P less than 0.05), although the loss was not as great as that at 3 months of study. The number of anti-hypertensive tablets taken by the group was significantly reduced both at 3 months by 60 per cent (P less than 0.01) and after 3.9 years by 49 per cent (P less than 0.01). No changes were observed in mean levels of total serum cholesterol and triglyceride levels although the significant rise in mean HDL-cholesterol levels observed at 3 months (P less than 0.01) was maintained in the long term (P less than 0.05). Analysis of two 24-h dietary histories on non-consecutive days after 3.9 years demonstrated close compliance with the intended regimen, particularly in intakes of sodium, fibre and carbohydrate. However, mean fat intake was 8 per cent above that of the intended dietary regimen. We conclude that the hypotensive response, accompanied by reduction in weight and antihypertensive drug therapy, and improvement in cardiovascular risk, may be maintained in the long term on the modified dietary regimen.