Clinical outcomes in the diabetes cohort of the international verapamil SR-trandolapril study

George L. Bakris, Efrain Gaxiola, Franz H. Messerli, Giuseppe Mancia, Serap Erdine, Rhonda Cooper-DeHoff, Carl J. Pepine

Research output: Contribution to journalArticlepeer-review


The INternational VErapamil SR-Trandolapril study (INVEST) had 6400 of 22 576 (28,3%) participants with diabetes at entry. The objectives of this prespecified analysis were to compare antihypertensive treatment strategies in the diabetes cohort (verapamil SR-based [n=3169] versus atenolol-based [n=3231]) and identify predictors for the primary outcome (a composite of first occurrence of all-cause death, nonfatal myocardial infarction, or nonfatal stroke). During a mean follow-up of 2.7 years, 913 participants with diabetes experienced a primary outcome event, with no significant difference between treatment strategies (14.6%, verapamil SR versus 13.9%; atenolol hazard ratio, 1.05; 95% confidence interval, 0.92 to 1.19). Risk for the primary outcome increased with presence of baseline heart failure, renal impairment, US residency, age, previous stroke/transient ischemie attack, previous myocardial infarction, peripheral vascular disease, or smoking. High systolic and diastolic pressures during follow-up also were associated with increased risk, as were low diastolic pressures. Antihypertensive treatment with a verapamil SR or atenolol strategy resulted in similar rates of cardiovascular outcomes in coronary artery disease (CAD) patients with diabetes. Thus, a verapamil SR-based antihypertensive treatment strategy is an alternative to a β-blocker-based strategy in adults with CAD and diabetes.

Original languageEnglish
Pages (from-to)637-642
Number of pages6
Issue number5
Publication statusPublished - Nov 2004


  • Blood pressure
  • Calcium antagonists
  • Coronary artery disease
  • Diabetes mellitus

ASJC Scopus subject areas

  • Internal Medicine


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