New Trials of Antihypertensive Drugs Outside the United States

Several therapeutic “hard end-point” trials in hypertension are currently in progress outside the US, eg the CAPPP (Captopril Prevention Project) in Sweden and Finland, N = 10,800, The NORDIL (Nordic Diltiazem) in Sweden and Norway, n >5,000 and still recruiting, TheSTOP-Hypertension-2 (Swedish Trial in Old Patients) in Sweden, N = 6,600 studies. These evaluate novel therapies (ACEI, CaA) vs. β-blockers and diuretics on CV mortality. The HOT (Hypertension Optimal Treatment) study is conducted in 26 countries worldwide, N=19,196. It evaluates the effect of felodipine-based therapy on CV morbidity and mortality when patients are randomized to 3 different target DBPs ≤90, ≤85 or ≤80 mm Hg. A low dose of aspirin, 75 mg/d or placebo is tested as well. All these trials are conducted in accordance with the PROBE design (Prospective Randomized Open Blinded End-point). An up-date as of May 1995 with some emphasis on The HOT Study will be presented.