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