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While the absence of statistical difference in Tcore might be surprising, it has to be acknowledged that the current exercise model leads to shorter time to exhaustion in hot trials (i.e. the rate of increase in Tcore was higher in hot than temperate trials).
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First, participants experienced noxious thermal stimulation on their left forearms (the "hot trial"), simulating the experience of spilling hot coffee on themselves.
However, in the HOT trial the diastolic blood pressure baseline standard deviation was 3.4 mmHg.
The HOT trial, one of the largest hypertension trials, is a good example of this phenomenon [8].
In contrast to the HOT trial the ALLHAT trial randomized 33,357 patients most of whom were selected because they were previously treated [9].
In the HOT trial the baseline systolic BP SD was 14.4, which is similar to our estimate of the value 14.0 mmHg noted in Table 1 and 3.
In the HOT trial 18,970 patients were randomized to three different TARGET blood pressures and a DBP of at least 100 mmHg was the entry criteria.
This suggests that in the HOT trial there must have been a large number of patients who had baseline diastolic blood pressures of 100 mmHg thus partially explaining the large reductions in BP seen in that trial in all 3 target groups.
The HOT trial completed its accrual in 2007, with 1,884 subjects enrolled [ 45].
One of the largest trials that addressed the question of what should be the optimal BP was the Hypertension Optimal Treatment (HOT) trial (7).
The Hypertension Optimal Treatment (HOT) trial studied whether the addition of aspirin to antihypertensive treatment reduced the risk of MACE compared with placebo [ 14, 15].
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