TY - JOUR
T1 - Clinical outcomes in the diabetes cohort of the international verapamil SR-trandolapril study
AU - Bakris, George L.
AU - Gaxiola, Efrain
AU - Messerli, Franz H.
AU - Mancia, Giuseppe
AU - Erdine, Serap
AU - Cooper-DeHoff, Rhonda
AU - Pepine, Carl J.
PY - 2004/11
Y1 - 2004/11
N2 - 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.
AB - 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.
KW - Blood pressure
KW - Calcium antagonists
KW - Coronary artery disease
KW - Diabetes mellitus
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U2 - 10.1161/01.HYP.0000143851.23721.26
DO - 10.1161/01.HYP.0000143851.23721.26
M3 - Article
C2 - 15381674
AN - SCOPUS:7244257384
VL - 44
SP - 637
EP - 642
JO - Hypertension
JF - Hypertension
SN - 0194-911X
IS - 5
ER -