摘要
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- tran- dolapril 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.
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.
