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Predictors of Adverse Outcome Among Patients With Hypertension and Coronary Artery Disease

Carl J. Pepine, MD, MACC^_*,_*, Peter R. Kowey, MD, FACC, Stuart Kupfer, MD, Rainer E. Kolloch, MD, Athanase Benetos, MD, PhD^||, Giuseppe Mancia, MD, PhD^¶, Antonio Coca, MD^#, Rhonda M. Cooper-DeHoff, PharmD^_*, Eileen Handberg, PhD^_*, Efrain Gaxiola, MD, FACC^_**, Peter Sleight, MD, FACC, C. Richard Conti, MD, MACC^_*, Ann C. Hewkin, MSc, Luigi Tavazzi, MD, FACC for the INVEST Investigators

^_* Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida
Lankenau Hospital, Wynnewood, Pennsylvania
Abbott, Abbott Park, Illinois
University of Munster School of Medicine, Bielefeld, Germany
^|| University of Nancy, Vandoeuvre-les-Nancy, France
^¶ Department of Medicine, University of Milano-Bicocca, Milano, Italy
^# Hospital Clinic, Barcelona, Spain
^** Instituto Cardiovascular de Guadalajara, Guadalajara, Mexico
University of Oxford, Oxford, United Kingdom
Prioario Division of Cardiology, Policlinico San Matteo, Pavia, Italy

View larger version (19K): [in a new window]   Figure 1 Predictors of increased risk (adjusted hazard ratio [HR] and 95% confidence interval [CI]) for the primary outcome. MI = myocardial infarction; PVD = peripheral vascular disease; TIA = transient ischemic attack. *Covariates forced into Cox model; other covariates selected at p 0.1; p < 0.001; p < 0.05; coronary bypass/percutaneous coronary intervention.

View larger version (15K): [in a new window]   Figure 2 Risk (adjusted hazard ratio [HR] and 95% confidence interval [CI]) for primary outcome associated with high-risk subgroups by time-dependent systolic blood pressure (SBP) category. In general, risk was lower when SBP was <140 mm Hg. See Figure 1 for definitions.

View larger version (21K): [in a new window]   Figure 3 Risk (hazard ratios [HRs] and 95% confidence intervals [CIs]) for primary outcome by strategy drugs and drug dose. Randomized treatment strategy was not a predictor of risk (Fig. 1). Selected doses of verapamil sustained released (SR) plus trandolapril were statistically significant, but all combinations showed beneficial trends compared with monotherapy. Reference is atenolol 50 mg/day. HCTZ = hydrochlorothiazide.