Long-Term Mortality in Hypertensive Patients With Coronary Artery Disease: Results From the US Cohort of the International Verapamil (SR)/Trandolapril Study.
The dyad of hypertension and coronary artery disease is prevalent; however, data on systolic blood pressure (SBP) control and long-term all-cause mortality are lacking. Using extended follow-up data from the US cohort of the International Verapamil (SR)/Trandolapril Study (mean 11.6 years), subjects were categorized by age at enrollment (50 to <60 and ≥60 years). Cox proportional adjusted hazard ratios (HRs) were constructed for time to all-cause mortality according to achieved mean SBP. In those 50 to <60 years and using a referent SBP of <130 mm Hg, an achieved SBP of 130 to 140 mm Hg was associated with a similar risk of mortality (HR, 1.03; 95% confidence interval [CI], 0.87-1.23), whereas an achieved SBP of ≥140 mm Hg was associated with an increased risk of mortality (HR, 1.80; 95% CI, 1.53-2.11). Among subjects aged ≥60 years and using a referent SBP of <130 mm Hg, an achieved SBP 130 to 140 mm Hg was associated with a lower mortality risk (HR, 0.92; 95% CI, 0.85-0.98). There was an increased risk of mortality with an achieved SBP ≥150 mm Hg (HR, 1.34; 95% CI, 1.23-1.45), but not with an achieved SBP 140 to 150 mm Hg (HR, 1.02; 95% CI, 0.94-1.11). In hypertensive patients with coronary artery disease, achieving a SBP of 130 to 140 mm Hg seems to be associated with lower all-cause mortality after ≈11.6 years of follow-up.



URL: http://www.clinicaltrials.gov. Unique identifier: NCT00133692.
From the Division of Cardiovascular Medicine, College of Medicine (I.Y.E., A.A.B., R.M.C, C.J.P.) and Department of Pharmacotherapy and Translational Research, College of Pharmacy (Y.G., R.M.C.), University of Florida, Gainesville; and Medical Service, Cardiology Section, North Florida/South Georgia Veterans Health System, Gainesville (A.A.B.). islam.elgendy@medicine.ufl.edu.
Islam Y
IY
Elgendy
From the Division of Cardiovascular Medicine, College of Medicine (I.Y.E., A.A.B., R.M.C, C.J.P.) and Department of Pharmacotherapy and Translational Research, College of Pharmacy (Y.G., R.M.C.), University of Florida, Gainesville; and Medical Service, Cardiology Section, North Florida/South Georgia Veterans Health System, Gainesville (A.A.B.).
Anthony A
AA
Bavry
From the Division of Cardiovascular Medicine, College of Medicine (I.Y.E., A.A.B., R.M.C, C.J.P.) and Department of Pharmacotherapy and Translational Research, College of Pharmacy (Y.G., R.M.C.), University of Florida, Gainesville; and Medical Service, Cardiology Section, North Florida/South Georgia Veterans Health System, Gainesville (A.A.B.).
Yan
Y
Gong
From the Division of Cardiovascular Medicine, College of Medicine (I.Y.E., A.A.B., R.M.C, C.J.P.) and Department of Pharmacotherapy and Translational Research, College of Pharmacy (Y.G., R.M.C.), University of Florida, Gainesville; and Medical Service, Cardiology Section, North Florida/South Georgia Veterans Health System, Gainesville (A.A.B.).
Eileen M
EM
Handberg
From the Division of Cardiovascular Medicine, College of Medicine (I.Y.E., A.A.B., R.M.C, C.J.P.) and Department of Pharmacotherapy and Translational Research, College of Pharmacy (Y.G., R.M.C.), University of Florida, Gainesville; and Medical Service, Cardiology Section, North Florida/South Georgia Veterans Health System, Gainesville (A.A.B.).
Rhonda M
RM
Cooper-DeHoff
From the Division of Cardiovascular Medicine, College of Medicine (I.Y.E., A.A.B., R.M.C, C.J.P.) and Department of Pharmacotherapy and Translational Research, College of Pharmacy (Y.G., R.M.C.), University of Florida, Gainesville; and Medical Service, Cardiology Section, North Florida/South Georgia Veterans Health System, Gainesville (A.A.B.).
Carl J
CJ
Pepine
D000368:Aged; D001795:Blood Pressure Determination; D002423:Cause of Death; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D007211:Indoles / Q000008:administration & dosage*; D038622:Internationality; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D013599:Systole / Q000187:drug effects; D016896:Treatment Outcome; D014481:United States; D014700:Verapamil / Q000008:administration & dosage*
D007211:Indoles; C052035:trandolapril; D014700:Verapamil
adult; blood pressure; coronary artery disease; hypertension; mortality