Influence of gender on prevention of myocardial infarction by antihypertensives and acetylsalicylic acid: the HOT study.

OBJECTIVE

The aims of the Hypertension Optimal Treatment (HOT) Study were to investigate the relationship between three levels of target office diastolic blood pressure (BP; < or = 90, < or = 85, and < or = 80 mm Hg) and cardiovascular death, myocardial infarction (MI), and stroke in hypertensive patients, and to examine the effects of 75 mg of acetylsalicylic acid (ASA) daily versus placebo.

METHODS

Randomized, double-blind study. This substudy assessed the influence of gender on the incidence of MI.

METHODS

A total of 18,790 patients (mean age, 61.5 years; range, 50-80 years).

METHODS

Patients were randomized and followed for an average of 3.8 years until 71,051 patient-years had elapsed and 683 events, including 215 MIs, had occurred.

RESULTS

There were significantly fewer MIs in the lowest diastolic BP target group (P = .034) in women (n = 8883); a similar but smaller trend was not statistically significant in men. The effect of ASA on preventing MI was also influenced by gender (P = .38 in women; P = .001 in men [lowered by 42%]).

CONCLUSIONS

Lowering diastolic BP to about 80 mm Hg in hypertensive women and administering 75 mg of ASA daily to well-treated hypertensive men reduces MI in patients with essential hypertension.