[The Hypertension Optimal Treatment (HOT) study: results of 12-month therapy related to age]

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R E Kolloch1, K H Rahn

  • 1Medizinische Klinik, Krankenanstalten Gilead, Bielefeld.

Deutsche Medizinische Wochenschrift (1946)
|February 18, 1998
PubMed

Insights

The Hypertension Optimal Treatment study found that intensive blood pressure reduction is well-tolerated by most hypertensive patients. Further research will explore cardiovascular outcomes with targeted diastolic pressures.

Area of Science:

  • Cardiovascular Medicine
  • Clinical Pharmacology
  • Hypertension Research

Background:

  • The Hypertension Optimal Treatment (HOT) study is a prospective, randomized, multicenter trial involving 19,193 hypertensive patients across 26 countries.
  • Key objectives include evaluating the impact of three diastolic pressure targets (< or = 90, < or = 85, < or = 80 mm Hg) on cardiovascular events.
  • The study also assesses the efficacy of low-dose aspirin (75 mg daily) versus placebo in reducing morbidity and mortality.

Purpose of the Study:

  • To determine the relationship between specific diastolic blood pressure targets and cardiovascular morbidity/mortality in hypertensive individuals.
  • To investigate the effect of low-dose aspirin on cardiovascular outcomes compared to placebo.
  • To assess the tolerability and feasibility of intensive blood pressure management strategies.

Main Methods:

  • 19,193 patients aged 50-80 years with diastolic blood pressure between 100-115 mm Hg were randomized.
  • Treatment initiated with felodipine, escalating to combination therapy with ACE inhibitors or beta-blockers, and diuretics as needed.
  • Patients were assigned to target diastolic pressures of < or = 90, < or = 85, or < or = 80 mm Hg.

Main Results:

  • After 12 months, average diastolic pressures achieved were 86, 83, and 81 mm Hg for the respective target groups.
  • Target attainment rates were 84% (<90 mmHg), 72% (<85 mmHg), and 57% (<80 mmHg), with higher rates in elderly patients.
  • Treatment was generally well-tolerated, with common side effects including ankle edema and cough, occurring in a small percentage of patients.

Conclusions:

  • One-year results demonstrate that intensive blood pressure reduction is achievable and well-tolerated in the majority of hypertensive patients.
  • These findings support the feasibility of pursuing lower diastolic pressure targets.
  • The study provides a foundation for answering the primary research questions regarding cardiovascular outcomes.
Abstract

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