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Hypertension Optimal Treatment (HOT) Trial, more than 19,000 patients were
randomized to 3 different target blood pressure levels (less than or equal
to 90 mm Hg, less than or equal to 85 mm Hg, or less than or equal to 80 mm
Hg) and treated with a long-acting calcium antagonist, felodipine. ACE
inhibitors, beta-blockers, and diuretics were added to reach target blood
pressure levels in each of the 3 groups as needed. In the 1,501 patients
with diabetes mellitus, the risk for a major cardiovascular event or
myocardial infarction was lowest in the group randomized to a target blood
pressure of less than or equal to 80 mm Hg. Despite the small difference in
diastolic target blood pressures, there was a substantial benefit as blood
pressure was lowered with treatment in the patients with diabetes mellitus.
These data also support the benefits of intensive blood pressure lowering in
diabetic patients with hypertension.
Hansson L, Zanchetti A, Carruthers SG, Dahlof B, Elmfeldt D, Julius S, Menard J, Rahn KH, Wedel H, Westerling S, for the HOT Study Group. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the Hypertension Optimal Treatment (HOT) randomised trial. Lancet 1998;351:1755-1762.