Influence of gender on prevention of myocardial infarction by antihypertensives and acetylsalicylic acid: the HOT study.
OBJECTIVE
The aims of the Hypertension Optimal Treatment (HOT) Study were to investigate the relationship between three levels of target office diastolic blood pressure (BP; < or = 90, < or = 85, and < or = 80 mm Hg) and cardiovascular death, myocardial infarction (MI), and stroke in hypertensive patients, and to examine the effects of 75 mg of acetylsalicylic acid (ASA) daily versus placebo.


METHODS
Randomized, double-blind study. This substudy assessed the influence of gender on the incidence of MI.


METHODS
A total of 18,790 patients (mean age, 61.5 years; range, 50-80 years).


METHODS
Patients were randomized and followed for an average of 3.8 years until 71,051 patient-years had elapsed and 683 events, including 215 MIs, had occurred.


RESULTS
There were significantly fewer MIs in the lowest diastolic BP target group (P = .034) in women (n = 8883); a similar but smaller trend was not statistically significant in men. The effect of ASA on preventing MI was also influenced by gender (P = .38 in women; P = .001 in men [lowered by 42%]).


CONCLUSIONS
Lowering diastolic BP to about 80 mm Hg in hypertensive women and administering 75 mg of ASA daily to well-treated hypertensive men reduces MI in patients with essential hypertension.
Department of Internal Medicine, Division of Cardiology, Ullevaal Hospital, N-0407 Oslo, Norway.
S E
SE
Kjeldsen
I
I
Warnold
L
L
Hansson
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D003971:Diastole / Q000187:drug effects; D004311:Double-Blind Method; D015736:Felodipine / Q000627:therapeutic use*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D016016:Proportional Hazards Models; D012737:Sex Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D005343:Fibrinolytic Agents; D015736:Felodipine; D001241:Aspirin