Herpin D, Mallion J M, Dahan R, Benkritly A, Boutelant S, Baguet J P, Noir-Clerc M
Service cardiologie B, CHU La Milétrie, Poitiers.
Arch Mal Coeur Vaiss. 1997 Aug;90(8):1175-9.
The objective of the HOT study, an international, prospective, randomised study was to determine the optimal level of the blood pressure under treatment, linked with the lowest cardiovascular mortality and morbidity. The target diastolic blood pressure of 80, 85 and 90 mmHg was determined at the randomisation. In order to reach the target blood pressure, a strategy of treatment was predefined: the 1st step was felodipine (a long acting dihydropyridine) and the next steps (if the blood pressure reduction was not enough) proposed the addition of different therapeutic classes and/or the increase of the doses of each drug. The blood pressure measurements were made, using the oscillometric method (automatic blood pressure measuring device, Hestia). The quality of the blood pressure control observed in the HOT study was verified after 6 months of follow-up ("Quality of the blood pressure control in the clinical practice and in the HOT study", for the French research group of the HOT study. French hypertension meeting, Paris, December 1994). The aim of this second evaluation was to see if the quality of this control was still effective in France and for all countries after 2 years of follow-up. At the inclusion, the mean diastolic blood pressure was 106 +/- 4 mmHg in France (n = 1.574) and 105 +/- 4 mmHg for all countries (n = 18.790). The results at 24 months were the following, according to the target groups: 79.9 for the < or = 80 mmHg target group; 82.1 for the < or = 85 mmHg target and 83.6 for the < or = 90 mmHg target group. The percentages of patients who reached the target blood pressure were respectively 74; 80; 89% for the 3 target groups. The number of antihypertensive treatments needed to reach this blood pressure control slightly increased in the 3 target groups between the first and the second year with a lower rate of monotherapy and a higher rate of bi and tritherapy. But in the 80 mmHg target group (the most strict), the monotherapy was used in more than half of the patients. In comparison with all countries, France had lower number of bi and tritherapies (i.e. in the 85 mmHg target group: 38.4% of bitherapy in France versus 45.6% in all countries).
after 2 years of follow-up, the quality of the blood pressure control is still good. There is a trend toward a slight increase in the number of antihypertensive drugs after the first year in the 3 target groups.
HOT研究是一项国际前瞻性随机研究，其目的是确定治疗中与最低心血管死亡率和发病率相关的最佳血压水平。随机分组时确定的目标舒张压为80、85和90 mmHg。为达到目标血压，预先制定了治疗策略：第一步是使用非洛地平（一种长效二氢吡啶类药物），后续步骤（如果血压降低不足）建议添加不同治疗类别药物和/或增加每种药物的剂量。使用示波法（自动血压测量装置，赫斯提亚）进行血压测量。在随访6个月后对HOT研究中观察到的血压控制质量进行了验证（“临床实践和HOT研究中的血压控制质量”，针对HOT研究的法国研究小组。1994年12月于巴黎召开的法国高血压会议）。第二次评估的目的是观察在随访2年后这种控制质量在法国以及所有国家是否仍然有效。纳入研究时，法国的平均舒张压为106±4 mmHg（n = 1574），所有国家为105±4 mmHg（n = 18790）。根据目标组，24个月时的结果如下：目标为≤80 mmHg组为79.9；目标为≤85 mmHg组为82.1；目标为≤90 mmHg组为83.6。三个目标组达到目标血压的患者百分比分别为74%、80%、89%。在第一年到第二年期间，三个目标组达到这种血压控制所需的抗高血压治疗数量略有增加，单一疗法的比例降低，联合疗法和三联疗法的比例升高。但在目标为80 mmHg的组（最严格的组）中，超过一半的患者使用单一疗法。与所有国家相比，法国联合疗法和三联疗法的使用数量更少（即在目标为85 mmHg的组中：法国联合疗法的比例为38.4%，所有国家为45.6%）。
随访2年后，血压控制质量仍然良好。三个目标组在第一年之后抗高血压药物数量有轻微增加的趋势。
