Predictors of adverse outcome among patients with hypertension and coronary artery disease.
J Am Coll Cardiol
; 47(3): 547-51, 2006 Feb 07.
Article
in En
| MEDLINE
| ID: mdl-16458134
ABSTRACT
OBJECTIVES:
We sought to determine predictors for adverse outcomes in hypertensive patients with coronary artery disease (CAD).BACKGROUND:
Factors leading to adverse outcomes in hypertensive patients with CAD are poorly understood. The INternational VErapamil-trandolapril STudy (INVEST) compared outcomes in hypertensive patients with CAD that were assigned randomly to either a verapamil sustained-release (SR)- or an atenolol-based strategy for blood pressure (BP) control. Trandolapril and hydrochlorothiazide were used as added agents. During follow-up (61,835 patient-years), BP control and the primary outcome (death, nonfatal myocardial infarction, and nonfatal stroke) were not different between strategies.METHODS:
We investigated risk for adverse outcome associated with baseline factors, follow-up BP, and drug treatments using Cox modeling.RESULTS:
Previous heart failure (adjusted hazard ratio [HR] 1.96), as well as diabetes (HR 1.77), increased age (HR 1.63), U.S. residency (HR 1.61), renal impairment (HR 1.50), stroke/transient ischemic attack (HR 1.43), smoking (HR 1.41), myocardial infarction (HR 1.34), peripheral vascular disease (HR 1.27), and revascularization (HR 1.15) predicted increased risk. Follow-up systolic BP <140 mm Hg or diastolic BP <90 mm Hg (HRs 0.82 or 0.70, respectively) and trandolapril with verapamil SR (HRs 0.78 and 0.79) were associated with reduced risk.CONCLUSIONS:
In hypertensive patients with CAD, increased risk for adverse outcomes was associated with conditions related to the severity of CAD and diminished left ventricular function. Lower follow-up BP and addition of trandolapril to verapamil SR each were associated with reduced risk.
Search on Google
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Coronary Artery Disease
/
Hypertension
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Humans
/
Middle aged
Language:
En
Journal:
J Am Coll Cardiol
Year:
2006
Document type:
Article
Affiliation country:
United States