- Email: [email protected]
TRANDOLAPRIL STUDY (INVEST) PROJECT
2015 JACC April 5, 2016 Volume 67, Issue 13
Prevention LONG-TERM MORTALITY IN A COHORT OF HYPERTENSIVE PATIENTS WITH CORONARY ARTERY DISEASE: RESULTS FROM AN EXTENDED FOLLOW UP OF THE INTERNATIONAL VERAPAMIL/ TRANDOLAPRIL STUDY (INVEST) PROJECT Poster Contributions Poster Area, South Hall A1 Monday, April 04, 2016, 9:45 a.m.-10:30 a.m. Session Title: The Epidemiology of Hypertension and Its Comorbidities Abstract Category: 34. Prevention: Hypertension Presentation Number: 1270-373 Authors: Islam Elgendy, Anthony Bavry, Yan Gong, Eileen Handberg, Rhonda Cooper-DeHoff, Carl Pepine, University of Florida, Gainesville, FL, USA, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
Background: The dyad of hypertension and coronary artery disease (CAD) is the most prevalent dyad in the Medicare population. Yet data regarding the systolic blood pressure (SBP) associated with the lowest long-term mortality are lacking in this population. Methods: Using extended follow-up (mean 10 yrs) data from a National Death Registry search of the United States cohort in the INVEST, subjects were categorized by age at enrollment (<60 and ≥60 years). Cox proportional adjusted hazard ratios (HR) were constructed for time to all-cause mortality according to achieved mean SBP during last 2-years of the active study.
Results: Among 17,131 patients, 6,031 died (35.2%) by the end of the extended follow-up. In those <60 years, with referent SBP ≥140 mm Hg, an achieved SBP <140 mm Hg was associated with lower mortality risk (HR 0.57, 95% confidence interval (CI) 0.49-0.65, p<0.0001). Among subjects ≥ 60 years, with referent SBP ≥150 mm Hg, an achieved SBP <140 mm Hg was associated with a lower mortality risk (HR 0.71, 95% CI 0.66-0.77, p<0.0001), as was an achieved SBP 140 to <150 mm Hg (HR 0.76, 95% CI 0.70-0.83, p<0.0001). A marginally lower mortality risk was observed among those with SBP <140 mm Hg (HR 0.93, 95% CI 0.87-1.00, p=0.05), vs. SBP 140 to <150 mm Hg. Conclusions: In patients aged <60 years with known CAD, achieving a SBP of <140 mm Hg was associated with lower all-cause mortality. Among those ≥60 years old, the subgroup that achieved an SBP <140 mm Hg appeared to have the lowest risk of all-cause mortality.
Prevention LONG-TERM MORTALITY IN A COHORT OF HYPERTENSIVE PATIENTS WITH CORONARY ARTERY DISEASE: RESULTS FROM AN EXTENDED FOLLOW UP OF THE INTERNATIONAL VERAPAMIL/ TRANDOLAPRIL STUDY (INVEST) PROJECT Poster Contributions Poster Area, South Hall A1 Monday, April 04, 2016, 9:45 a.m.-10:30 a.m. Session Title: The Epidemiology of Hypertension and Its Comorbidities Abstract Category: 34. Prevention: Hypertension Presentation Number: 1270-373 Authors: Islam Elgendy, Anthony Bavry, Yan Gong, Eileen Handberg, Rhonda Cooper-DeHoff, Carl Pepine, University of Florida, Gainesville, FL, USA, North Florida/South Georgia Veterans Health System, Gainesville, FL, USA
Background: The dyad of hypertension and coronary artery disease (CAD) is the most prevalent dyad in the Medicare population. Yet data regarding the systolic blood pressure (SBP) associated with the lowest long-term mortality are lacking in this population. Methods: Using extended follow-up (mean 10 yrs) data from a National Death Registry search of the United States cohort in the INVEST, subjects were categorized by age at enrollment (<60 and ≥60 years). Cox proportional adjusted hazard ratios (HR) were constructed for time to all-cause mortality according to achieved mean SBP during last 2-years of the active study.
Results: Among 17,131 patients, 6,031 died (35.2%) by the end of the extended follow-up. In those <60 years, with referent SBP ≥140 mm Hg, an achieved SBP <140 mm Hg was associated with lower mortality risk (HR 0.57, 95% confidence interval (CI) 0.49-0.65, p<0.0001). Among subjects ≥ 60 years, with referent SBP ≥150 mm Hg, an achieved SBP <140 mm Hg was associated with a lower mortality risk (HR 0.71, 95% CI 0.66-0.77, p<0.0001), as was an achieved SBP 140 to <150 mm Hg (HR 0.76, 95% CI 0.70-0.83, p<0.0001). A marginally lower mortality risk was observed among those with SBP <140 mm Hg (HR 0.93, 95% CI 0.87-1.00, p=0.05), vs. SBP 140 to <150 mm Hg. Conclusions: In patients aged <60 years with known CAD, achieving a SBP of <140 mm Hg was associated with lower all-cause mortality. Among those ≥60 years old, the subgroup that achieved an SBP <140 mm Hg appeared to have the lowest risk of all-cause mortality.