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--patient characteristics: randomization, risk profiles, and early blood pressure results.
The Hypertension Optimal Treatment ( HOT ) Study is a prospect i ve , r and omized , multicenter trial being conducted in 26 countries . Its main aim is to evaluate the relationship between three levels of target diastolic blood pressure ( < or = 90 , < or = 85 or < or = 80 mmHg ) and cardiovascular morbidity and mortality in hypertensive patients . In addition , the study will examine the effects on morbidity and mortality of a low dose , 75 mg daily , of acetylsalicylic acid ( ASA , aspirin ) or placebo . In the HOT Study , basic antihypertensive treatment is initiated with the calcium antagonist felodipine at a dose of 5 mg daily . If target blood pressure is not reached , additional antihypertensive therapy with either an angiotensin converting enzyme ( ACE ) inhibitor or a beta-adrenoceptor blocking agent is given . Further dosage adjustments are made in accordance with a set protocol . As a fifth and final step , a diuretic may be added . Inclusion of patients was stopped on April 30 , 1994 . At that time 19,196 patients had been r and omized . There were 9,055 ( 47 % ) women and 10,141 ( 53 % ) men with an average age of 61.5 + /- 7.5 ( SD ) years . At enrollment , 52 % of patients were receiving antihypertensive treatment . These patients entered a wash-out period of at least 2 weeks before r and omization . The average r and omization blood pressure in untreated patients was 169 + /- 14/106 + /- 3 mmHg and in the treated patients 170 + /- 14/105 + /- 3 mmHg . On August 15 , 1994 , blood pressure data were available for 14,710 and 10,275 patients , who had completed 3 and 6 months treatment , respectively . The average reduction in diastolic blood pressure was 22 mmHg after 6 months . ( ABSTRACT TRUNCATED AT 250 WORDS
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 ) .