Spanish contribution to the HOT (Hypertension Optimal Treatment) study. Final results

BACKGROUND: The HOT study is a multicenter international trial which includ ed 19,193 patients and whose goal was to assess the optimal target diastoli c blood pressure to achieve by antihypertensive treatment. PATIENTS AND METHODS: Patients were recruited in 26 countries. Spain contri buted with 806 patients (4.3%) who were randomized to achieve three target DBP: less than or equal to 90; less than or equal to 85; and less than or e qual to 80 mmHg, respectivelly. Baseline characteristics, blood pressure ac hieved by treatment and cardiovascular events are described and compared wi th 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 antihyperte nsive treatment and not controlled at inclusion. There were significant dif ferences in gender, higher number of females (p > 0.001), less prevalence o f tobacco consumption (p = 0.014), and a fewer number of patients with angi na (p > 0.001) and myocardial infarction (p > 0.04) between the Spanish sam ple and the whale HOT population. The percentage of patients reaching the r andomized 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 cardiovascu lar events in the Spanish population was 40 (4.96%), a similar incidence to the observed (687 events) in the whole study papulation (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 th ese patients.