Systolic blood pressure and subjective well-being in patients with coronary artery disease.
BACKGROUND
Limited information exists regarding the association between subjective well-being (SWB) and systolic blood pressure (SBP) among hypertensive patients with coronary artery disease (CAD).


OBJECTIVE
We tested the hypothesis that there is an association between SBP and SWB.


METHODS
We studied 22,576 hypertensive CAD patients > or = 50 years old in the INternational VErapamil SR-Trandolapril Study (INVEST), a randomized, blinded-endpoint trial of antihypertensive therapy in stable CAD patients. At each study visit, patients rated their SWB in the previous 4 weeks as "excellent," "good," "fair," or "poor" prior to SBP recordings. The outcome measure was SWB of "fair" or "poor." A longitudinal analysis using generalized estimating equations was performed to assess the association between SBP and odds of reporting fair/poor SWB, controlling for baseline SWB of fair/poor and angina reported during the study.


RESULTS
Patients with higher SBP had higher odds of reporting fair/poor SWB. Specifically, compared with patients with SBP of < or = 120, patients with SBP 140-150 > 150 - < or = 160 and > 160 had about 90% and 2.5 times greater odds of feeling fair/poor, respectively (adjusted odds ratio [OR]: 1.5990, 95% confidence interval [CI]: 1.81-2.00 and adjusted OR: 2.53, 95% CI: 2.41-2.66). Those who reported angina in the 4 wks prior to a protocol visit had 2.2 times greater odds of reporting fair/poor SWB (adjusted OR: 2.2, 95% CI: 2.13-2.27). Female gender, black race, history of smoking, diabetes, myocardial infarction, stroke, and cancer also increased the odds of reporting fair/poor SWB.


CONCLUSIONS
Among hypertensive CAD patients, higher on-treatment SBP is associated with greater odds of fair/poor SWB during follow-up.
Gong
Yan
Y
College of Pharmacy, University of Florida, Gainesville, FL 32610, USA.
Handberg
Eileen M
EM
Gerhard
Tobias
T
Cooper-Dehoff
Rhonda M
RM
Ried
L Douglas
LD
Johnson
Julie A
JA
Pepine
Carl J
CJ
D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D003324:Coronary Artery Disease / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology; D007211:Indoles / Q000627:therapeutic use; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D016017:Odds Ratio; D011788:Quality of Life; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013599:Systole; D013997:Time Factors; D016896:Treatment Outcome; D014700:Verapamil / Q000627:therapeutic use
D000959:Antihypertensive Agents; D007211:Indoles; C052035:trandolapril; D001262:Atenolol; D014700:Verapamil