October 1, 2001Journal of Hypertension
Twenty-four hour ambulatory blood pressure in the Hypertension Optimal Treatment (HOT) study
Key result
Antihypertensive treatment reduced office and 24-hour ambulatory blood pressures, with baseline ambulatory pressures (146/90 mmHg) significantly lower than office pressures (170/105 mmHg, P<0.01).
Why the study?
Does intensive antihypertensive treatment targeting lower office diastolic blood pressures improve 24-hour ambulatory blood pressure profiles in hypertensive patients?
Population
347 hypertensive patients from the HOT study undergoing both office measurement and 24 h ambulatory blood…
Comparison
Antihypertensive treatment targeting office… vs Antihypertensive treatment targeting office…
Design
RCT, randomized to a target office diastolic blood pressure ≤90 mmHg, ≤85…
Follow-up
median 2 years
Authors
Discussion
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Implication
Intensive targets improve 24-hour ambulatory control; extends HOT event-reduction benefits to out-of-office BP profiles.
Study Design
Type
RCT (n=347)
Structured PICO
Does intensive antihypertensive treatment targeting lower office diastolic blood pressures improve 24-hour ambulatory blood pressure profiles in hypertensive patients?
P
Population
347 hypertensive patients from the HOT study undergoing both office measurement and 24 h ambulatory blood pressure monitoring, mean age 62 +/- 7 years.
I
Intervention
Antihypertensive treatment (felodipine-based, with optional ACE-inhibitor, beta-blocker, or diuretic) targeting office diastolic blood pressure ≤85 mmHg or ≤80 mmHg
C
Comparator
Antihypertensive treatment targeting office diastolic blood pressure ≤90 mmHg
O
Outcome
24 h, day and night ambulatory blood pressure valuessurrogate
In the HOT study, antihypertensive treatment effectively reduced both office and 24-hour ambulatory blood pressures, with the lowest target group achieving the best trough-to-peak ratios and smoothness indices.
Cite This Study
Mancia et al. (2001) conducted an RCT in Hypertension (n=347). Antihypertensive treatment targeting diastolic blood pressure ≤90, ≤85, or ≤80 mmHg vs. Different diastolic blood pressure targets was evaluated on Change in office and 24-hour ambulatory blood pressure. Antihypertensive treatment reduced office and 24-hour ambulatory blood pressures, with baseline ambulatory pressures (146/90 mmHg) significantly lower than office pressures (170/105 mmHg, P<0.01).