Long-Term Mortality in Hypertensive Patients With Coronary Artery Disease

The dyad of hypertension and coronary artery disease is prevalent; however, data on systolic blood pressure (SBP) control and long-term all-cause mortality are lacking. Using extended follow-up data from the US cohort of the International Verapamil (SR)/Trandolapril Study (mean 11.6 years), subjects were categorized by age at enrollment (50 to <60 and ≥60 years). Cox proportional adjusted hazard ratios (HRs) were constructed for time to all-cause mortality according to achieved mean SBP. In those 50 to <60 years and using a referent SBP of <130 mm Hg, an achieved SBP of 130 to 140 mm Hg was associated with a similar risk of mortality (HR, 1.03; 95% confidence interval [CI], 0.87-1.23), whereas an achieved SBP of ≥140 mm Hg was associated with an increased risk of mortality (HR, 1.80; 95% CI, 1.53-2.11). Among subjects aged ≥60 years and using a referent SBP of <130 mm Hg, an achieved SBP 130 to 140 mm Hg was associated with a lower mortality risk (HR, 0.92; 95% CI, 0.85-0.98). There was an increased risk of mortality with an achieved SBP ≥150 mm Hg (HR, 1.34; 95% CI, 1.23-1.45), but not with an achieved SBP 140 to 150 mm Hg (HR, 1.02; 95% CI, 0.94-1.11). In hypertensive patients with coronary artery disease, achieving a SBP of 130 to 140 mm Hg seems to be associated with lower all-cause mortality after ≈11.6 years of follow-up. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00133692.