BP control and CV outcomes in hispanic and nonhispanic women with CAD and hypertension: Findings from invest

Prospective data regarding BP control and CV outcomes in minority women are lacking, despite the growing prevalence of HTN, heart disease and the minority population. An analysis of the 4,909 Hispanic (H) women with CAD and HTN enrolled in the International Verapamil SR/Trandolapril Study (INVEST) was conducted, and comparisons were made to the 6861 non-Hispanic (NH) women with regard to baseline characteristics, BP control and CV outcomes. Patients were randomized to either a verapamil SR- or an atenolol-based antihypertensive strategy. Dose titration and additional drugs (trandolapril and/or HCTZ) could be prescribed for BP control according to JNC VI goals. The primary outcome (PO) was first occurrence of death, nonfatal MI, or nonfatal stroke. There were no differences comparing the strategies with regard to CV outcomes in either H or NH women. Baseline characteristics comparing H and NH women are summarized in the Table. At 24 months, BP control was achieved in 66% and 57% of H and NH women, respectively (p<0.001), and a majority of H and NH women were treated with >/=2 strategy drugs (71% and 69% respectively). 5.7% of H and 11.4% of NH women experienced the PO. A stepwise model for time to PO, adjusting for differences in baseline characteristics, indicated a significant difference between H and NH women (HR=0.87, 95%CI=0.78-0.96, p=0.008). These data add significantly to what is known about hypertension and CAD in H and NH women. BP can be significantly reduced with either a verapamil SR or atenolol strategy and requires treatment with more than one antihypertensive in most. H women experienced significantly fewer adverse CV outcomes compared to NH women, which is, in part, explained by significantly fewer baseline co-morbidities.