Arquivos Brasileiros de Cardiologia

Resumo das Próximas Publicações

Ano 2001

Reduction in Diastolic Blood Pressure and Cardiovascular Mortality in Nondiabetic Hypertensive Patients. A Reanalysis of the HOT Study

In Portuguese

Antonio Alberto Lopes, Jadelson Andrade, Antonio Carlos Beisel Noblat, Marco Antonio Silveira

Objective – To use data published Hypertension Optimal Treatment (HOT) Study data to evaluate modifications in cardiovascular mortality in nondiabetic hypertensive patients according to the degree of reduction in their diastolic blood pressure.

Methods - Fatal cardiovascular events and the total of individuals/year for the group of nondiabetics in the HOT Study were estimated from data from tables presented in a previous publication. In the HOT Study, 18,700 patients from various centers were allocated at random to groups having different objectives of for diastolic blood pressure: £ 90 (n=6264); £ 85 (n=6264); £ 80mmHg (n=6262). Felodipine was the basic drug used. Other antihypertensive drugs were administered in a sequential manner, aiming at the objectives of diastolic blood pressure reduction.

Results - The group of nondiabetic hypertensive subjects with diastolic pressure £ 80mmHg had a cardiovascular mortality ratio of 4.1/1000 patients/year, 35.5% higher than the group with diastolic pressure £ 90mmHg (cardiovascular mortality ratio, 3.1/1000 patients/year). In contrast, diabetic patients allocated to the diastolic pressure objective group of £ 80mmHg had a 66.7% reduction in cardiovascular mortality (3.7/1000 patients/year) when compared with the diastolic pressure group of £ 90mmHg (cardiovascular mortality ratio, 11.1/1000 patients/year).

Conclusion – The results obtained indicate that in hypertensive diabetic patients reduction in diastolic blood pressure to levels £ 80mmHg decreases the risk of fatal cardiovascular events, but that in nondiabetic patients such mortality is higher in patients allocated to the diastolic blood pressure group of £ 80mmHg. Therefore, it still remains necessary to define the level of diastolic blood pressure £ 90mmHg at which maximal reduction in cardiovascular mortality is obtained for nondiabetics.

Key words: arterial hypertension, HOT Study, diabetes mellitus

Índice

Hospital Universitário Professor Edgar Santos – Universidade Federal da Bahia

Mailing address: Antonio Alberto Lopes - Rua Marechal Floriano, 448/1301 – 40110-010

Salvador, BA

E-mail: aaslopes@ufba.br