Influence of Hispanic ethnicity on blood pressure control and cardiovascular outcomes in women with CAD and hypertension: findings from INVEST.
BACKGROUND
Prospective data regarding blood pressure (BP) control and cardiovascular (CV) outcomes in Hispanic women are lacking.


METHODS
We analyzed 5017 Hispanic and 4710 non-Hispanic white hypertensive women with coronary artery disease (CAD) in the INternational VErapamil SR/Trandolapril STudy (INVEST) to determine the impact of baseline characteristics and BP control on CV outcomes.


RESULTS
At baseline, Hispanic women were younger and a had lower prevalence of most established CV risk factors than non-Hispanic white women. At 24 months, BP control (< 140/90 mm Hg) was achieved in 75% of Hispanic and 68% of non-Hispanic white women, (p < 0.001), with most women, regardless of ethnicity, requiring > or =2 antihypertensive agents. Following 26,113 patient-years of follow-up, the primary outcome (first occurrence of nonfatal myocardial infarction [MI], nonfatal stroke, or all cause death) occurred in 5.7% of Hispanic and 12.3% of non-Hispanic white women (adjusted HR = 0.84, 95% CI = 0.71-0.98, p = 0.03). There was no difference in outcome in either group of women comparing the randomized antihypertensive treatment strategies.


CONCLUSIONS
Despite accounting for a lower risk profile, deployment of protocol-based antihypertensive treatment regimens resulted in superior BP control and fewer CV events in Hispanic women compared with non-Hispanic white women.
Cooper-DeHoff
Rhonda M
RM
Division of Cardiovascular Medicine, University of Florida College of Medicine, Gainesville, Florida 32610, USA. dehofrm@medicine.ufl.edu
Zhou
Qian
Q
Gaxiola
Efrain
E
Cangiano
Jose L
JL
Garcia-Barreto
David
D
Handberg
Eileen
E
Pepine
Carl J
CJ
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D016001:Confidence Intervals; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D006852:Hydrochlorothiazide / Q000627:therapeutic use; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology*; D007211:Indoles / Q000627:therapeutic use; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D016896:Treatment Outcome; D044465:White People / Q000706:statistics & numerical data*; D016387:Women's Health
D000959:Antihypertensive Agents; D007211:Indoles; D006852:Hydrochlorothiazide; C052035:trandolapril