[Repercussions in clinical practice of the results of the HOT (Hypertension Optimal Treatment) study].
The HOT study (Hypertension Optimal Treatment) was designed to answer three questions: What is the optimum target diastolic blood pressure (DBP) level that treatment should reach for the greatest reduction in cardiovascular mortality risk; whether there are additional benefits with a progressive reduction of diastolic blood pressure from 90 to below 80 mmHg; and whether low-dose acetylsalicylic acid is of any additional benefit in the primary prevention of myocardial infarction in treated hypertensive patients? To resolve this posing, more than 19,000 essential hypertensives were recruited in 26 countries worldwide by 1,904 investigators with a follow-up period of almost 4 years. Patients were randomly assigned to three different diastolic blood pressure targets: < or = 90 mmHg, < or = 85 mmHg or < or = 80 mmHg respectively. Additionally, in each group, patients were randomly assigned to acetylsalicylic acid or placebo. The follow-up period was about 4 years. Although the HOT trial failed to demonstrate the primary objective for which it was designed, of defining optimum target diastolic blood pressure to be achieved by antihypertensive treatment, this HOT study has helped to clarify very important issues related to blood pressure lowering such as the nonexistence of the J-shaped curve concept in hypertension, the possibility of achieving substantial improvement in blood pressure control by the use of antihypertensive combination therapy, the additional benefit of low-dose aspirin in primary prevention of myocardial infarction among treated hypertensives, and the demonstration of the necessity of reducing diastolic blood pressure below 80 mmHg in diabetic hypertensive patients. For all these reasons, the HOT study is destined to become among the most relevant hypertension intervention studies of this century.
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D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
Repercusión en la práctica clínica de los resultados del estudio HOT.