Compliance with aspirin or placebo in the hypertension optimal treatment (HOT) study

Objective The Hypertension Optimal Treatment (HOT) study is a large, prospe ctive trial aimed at defining the level of diastolic blood pressure require d during antihypertensive therapy in order to achieve maximal protection ag ainst cardiovascular complications. A further aim is to assess the effects an morbidity and mortality of a 75 mg daily dose of aspirin compared with p lacebo. Subjects and methods Compliance with double-blind administration of aspirin or placebo added to antihypertensive treatment was evaluated for 1 year in a subset (n = 530) of the study population (n =18 790) by placing the medi cation in a container closed with an electronic cap that records precisely the time of each opening. Results The 1-year compliance rate (percentage of days with one opening per day) could be assessed in 501 patients. It averaged 78.3 +/- 25% in aspiri n-treated patients (n = 236, mean +/- SD), compared with 78.5 +/- 25% in pa tients having received placebo (n = 265), and was not influenced by age, se x or country (Germany, Italy, Switzerland, UK), The compliance rate was als o similar irrespective of whether the patients had reached their target blo od pressure, but was significantly better during the first than the second 6-month monitoring period (84.1 +/- 22% versus 72.3 +/- 32%, n = 501), Conclusions The high rate of compliance with aspirin or placebo observed in the HOT study suggests that the patients were highly motivated and may acc ount for the unusually good blood pressure control achieved in this trial d uring long-term anti-hypertensive treatment. I Hypertens 1999, 17:1041-1045 (C) Lippincott Williams & Wilkins.