[Spanish contribution to the HOT (Hypertension Optimal Treatment) study. Final results. Spanish Investigators in the HOT study].

BACKGROUND

The HOT study is a multicenter international trial which included 19,193 patients and whose goal was to assess the optimal target diastolic blood pressure to achieve by antihypertensive treatment.

PATIENTS AND METHODS

Patients were recruited in 26 countries. Spain contributed with 806 patients (4.3%) who were randomized to achieve three target DBP: < or = 90; < or = 85; and < or = 80 mmHg, respectively. Baseline characteristics, blood pressure achieved by treatment and cardiovascular events are described and compared with the whole HOT sample.

RESULTS

Mean age of the 806 Spanish patients was 61.9 +/- 7.3 years (range 50-80), 58.2% being women. About 55.6% were on pharmacological antihypertensive treatment and not controlled at inclusion. There were significant differences in gender, higher number of females (p > 0.001), less prevalence of tobacco consumption (p = 0.014), and a fewer number of patients with angina (p > 0.001) and myocardial infarction (p > 0.04) between the Spanish sample and the whole HOT population. The percentage of patients reaching the randomized target blood pressure was 76.5% at the end of the study. Average systolic and diastolic blood pressure reduction was 28.5 mmHg, and 23 mmHg respectively. The average number of drugs required per patient was 1.7 (57.6% needed two or more antihypertensive drugs) and the number of cardiovascular events in the Spanish population was 40 (4.96%), a similar incidence to the observed (687 events) in the whole study population (3.65%; p = 0.06).

CONCLUSION

Strategies of intensive treatment with current antihypertensive drugs are capable to achieve blood pressure control in the great majority of Spanish essential hypertensive patients without significant side effects, thus being responsible for a very low rate of cardiovascular events in these patients.