Treating patients to lower than st and ard BP targets , < /=140 - 160/90 - 100 mmHg , does not reduce mortality or morbidity .
BACKGROUND When treating elevated blood pressure , doctors need to know what blood pressure ( BP ) target they should try to achieve .
The st and ard of clinical practice for some time has been < /= 140 - 160/ 90 - 100 mmHg .
New guidelines are recommending BP targets lower than this st and ard .
It is not known whether attempting to achieve targets lower than the st and ard reduces mortality and morbidity .
OBJECTIVES To determine if lower BP targets ( < /= 135/85 mmHg ) are associated with reduction in mortality and morbidity as compared with st and ard BP targets ( < /= 140 - 160/ 90 - 100 mmHg ) .
The Hypertension Optimal Treatment (HOT) Study: 24-month data on blood pressure and tolerability.
The Hypertension Optimal Treatment ( HOT ) Study is an ongoing prospect i ve r and omized , multicentre trial conducted in 26 countries . There are two main aims of the study . The first is to evaluate the relationship between three levels of target diastolic blood pressure ( < or = 90 , < or = 85 or < or = 80 mmHg ) and the incidence of cardiovascular morbidity and mortality in hypertensive patients . The second is to determine the effect on morbidity and mortality of a low dose , 75 mg daily , of acetylsalicylic acid ( ASA , aspirin ) compared with placebo .  Altogether 18,790 patients have been recruited and r and omized , and two-year data are now available for all patients . This is a report on the blood pressures achieved , the tolerability , and other available data after 24 months of follow-up of all patients . Special emphasis is given to the subgroup of elderly patients ( > or = 65 years , n = 5988 ) compared with young patients ( < 65 years , n = 12 802 ) . On average , patients in the < or = 90 mmHg diastolic blood pressure target group have reached 85 mmHg , in the < or = 85 mmHg target group patients have reached 83 mmHg and in the < or = 80 mmHg target group patients have reached 81 mmHg . The percentage of those achieving target blood pressure in each target group at 24 months of follow-up is 85 % in the < or = 90 mmHg target group , 75 % in the < or = 85 mmHg target group and 57 % in the < or = 80 mmHg target group . In the elderly subgroup ( > or = 65 years of age ) , the percentage of patients achieving target at 24 months is higher for all target groups , namely 89 % in the < or = 90 mmHg group , 80 % in the 85 mmHg group and 62 % in the 80 mmHg group . Antihypertensive treatment was initiated with a calcium antagonist , felodipine , at a dose of 5 mg once daily . If target blood pressure was not reached , additional antihypertensive therapy , with either an angiotensin converting enzyme ( ACE ) inhibitor or a beta-adrenoceptor blocking agent , was given . Further dose adjustments were made in accordance with a set protocol . As a fifth , and final , step , a diuretic could be added . There have been relatively few side effects in this large , multinational study of hypertensive patients . Only ankle oedema and coughing exceed a frequency of 0.5 % ( ankle oedema 1.3 % in young and 1.7 % in elderly ; coughing 0.5 % in young and elderly ) . After two years , 84 % of all patients are still taking their baseline therapy , felodipine . The 24-month data presented here indicate that it should be possible to fulfil the primary aims of the HOT Study
Treating patients to lower than st and ard BP targets , < /=140 - 160/90 - 100 mmHg , does not reduce mortality or morbidity .
BACKGROUND When treating elevated blood pressure , doctors need to know what blood pressure ( BP ) target they should try to achieve .
The st and ard of clinical practice for some time has been < /= 140 - 160/ 90 - 100 mmHg .
New guidelines are recommending BP targets lower than this st and ard .
It is not known whether attempting to achieve targets lower than the st and ard reduces mortality and morbidity .
OBJECTIVES To determine if lower BP targets ( < /= 135/85 mmHg ) are associated with reduction in mortality and morbidity as compared with st and ard BP targets ( < /= 140 - 160/ 90 - 100 mmHg ) .