ASTRA printed an advertisement in the Swedish journal Läkartidningen
claiming that the HOT study shows that the DBP should be reduced to 85 mm
Hg- which seems to be a violation of the data analysis-
The advertisement is not used in the latest issue of Läkartidningen...
maybe as a result of our critical remarks.
In Norway, we have had a debate in our national medical journal, where one
of our national experts on hypertension did not respond directly the
statements in our letter to the editor (copied to list earlier on) where we
were critical to the conclusions drawn, but replied with other non-relevant
statements. In the next issue, the editor also concluded that there were
some inconsistencies in the conclusions.
Soon there will be held ASTRA-symposias, and we do of course hope that the
critical remarks on this list and that the letters to The Lancet will be
taken into account. At least we hope that our national "blood pressure
guru" will have done so... Also we have tried to get some discussion on our
GP-list and the gp-wonca list.
With due respect to the trial managers and all patients involved, sacrifice
of time and money- this is the largest hypertension trial yet: The HOT
trial seems to be a negative trial concerning Ca-antagonist's efficacy, and
certainly no evidence for reducing the diastolic target blood pressure,
except for diabetics- just one more nail to the ca-antagonist coffin?
I think the HOT trial illustrates how difficult, but necessary, critical
appraisal is, and that we as practitioners have to be alert.
Atle Klovning, MD, Research Fellow,
Specialist in General Practice/Family Medicine
Div. for General Practice,
University of Bergen, Norway
(+47) 55 58 67 09
(+47) 55 58 67 10 (FAX)
http://www.uib.no/isf/people/atle/
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