Donate Help Contact The AHA Sign In Home
American Heart Association
Hypertension
Search: search_blue_button Advanced Search
Published Online
on February 23, 2009

Hypertension. 2009
Published online before print February 23, 2009, doi: 10.1161/HYPERTENSIONAHA.108.111542
A more recent version of this article appeared on April 1, 2009
This Article
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
53/4/624    most recent
HYPERTENSIONAHA.108.111542v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Denardo, S. J.
Right arrow Articles by Pepine, C. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Denardo, S. J.
Right arrow Articles by Pepine, C. J.
Related Collections
Right arrow Cardiovascular Pharmacology
Right arrow Secondary prevention
Right arrow Risk Factors
Right arrow Clinical Studies
Right arrow CV surgery: coronary artery disease
Right arrow Chronic ischemic heart disease
Right arrow Coronary circulation

Submitted on February 14, 2008
Revised on March 10, 2008

Characteristics and Outcomes of Revascularized Patients With Hypertension. An International Verapamil SR-Trandolapril Substudy

Scott J. Denardo*; Franz H. Messerli; Efrain Gaxiola; Juan M. Aranda Jr; Rhonda M. Cooper-DeHoff; Eileen M. Handberg; Yan Gong; Annette Champion; Qian Zhou; and Carl J. Pepine

From the Division of Cardiovascular Medicine, College of Medicine (S.J.D., J.M.A., R.M.C-D., E.M.H., C.J.P.), and Center for Pharmacogenomics, College of Pharmacy (Y.G.), University of Florida, Gainesville; Division of Cardiology, St Luke's-Roosevelt Hospital Center and Columbia University, College of Medicine and Physicians (F.H.M.), New York, NY; Division of Clinical Cardiology, Jardínes Hospital de Especialidades (E.G.), Guadalajara, Mexico; and Abbott Laboratory (A.C., Q.Z.), Abbott Park, Ill.

* To whom correspondence should be addressed. E-mail: scott.denardo{at}medicine.ufl.edu.

Abstract—Our understanding of the growing population of revascularized patients with hypertension is limited. We retrospectively analyzed the International Verapamil SR-Trandolapril Study, which randomized coronary artery disease patients with hypertension to either verapamil SR- or atenolol-based treatment strategies, focusing on characteristics and outcomes of 6166 previously revascularized patients compared with 16 410 nonrevascularized patients. Revascularized patients had a history of coronary artery bypass grafting (45.2%), percutaneous coronary intervention (42.1%), or both (12.8%). Compared with nonrevascularized patients, revascularized patients at baseline demonstrated a higher prevalence of coronary artery disease risk factors and risk conditions (P<0.001). This higher prevalence was the principal cause of a higher incidence of primary outcome (death, nonfatal myocardial infarction, or nonfatal stroke) among revascularized patients (14.2% versus 8.5% for nonrevascularized patients; P<0.001). However, both patient groups demonstrated a relatively low incidence of subsequent revascularization (5.1% versus 1.5% respectively; P<0.0001). Associations between adjusted hazard ratio for primary outcome and follow-up blood pressure appeared "J shaped" for both patient groups. Because, as a group, revascularized patients with hypertension had worse outcomes compared with nonrevascularized patients, management of blood pressure to a specific target in future studies could result in improved outcomes.


Key words: hypertension • blood pressure • coronary artery disease • revascularization • coronary artery bypass grafting • percutaneous coronary intervention • epidemiology