Outcomes Among Hypertensive Patients With Concomitant Peripheral and Coronary Artery Disease: Findings From the INternational VErapamil-SR/Trandolapril STudy
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Hypertension is a common risk factor for peripheral arterial disease (PAD). Guidelines suggest treating PAD patients to a blood pressure <130/80 mm Hg; therefore, our objective was to explore whether attainment of this target blood pressure is associated with improved outcomes. We performed a post hoc analysis of the INternational VErapamil-SR/Trandolapril STudy, a randomized clinical trial, which included hypertensive patients with concomitant PAD and coronary artery disease. There were 2699 PAD patients followed for a mean of 2.7 years (60 970 patient-years). The primary outcome, all-cause death, nonfatal myocardial infarction, or nonfatal stroke, occurred in 16.3% of PAD patients versus 9.2% without PAD (adjusted hazard ratio: 1.26 [95% CI: 1.13 to 1.40]; P <0.0001). The primary outcome occurred least frequently among PAD patients treated to an average systolic blood pressure of 135 to 145 mm Hg and an average diastolic blood pressure of 60 to 90 mm Hg. PAD patients displayed a J-shape relationship with systolic blood pressure and the primary outcome, although individuals without PAD did not. PAD patients may require a different target blood pressure than those without PAD.
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Racial and ethnic disparities in revascularization for patients with PAD have been well documented since the 1990s.
“Racial and ethnic disparities in revascularization for patients with PAD have been well documented since the 1990s.87,106”
From Racial and Ethnic Disparities in Peripheral Artery Disease (2021) · cites this paper as [87]
The Methods (Post Hoc Analysis/Outcomes; page unavailable) include peripheral vascular interventions among the procedures tracked, but the Results (Effect of Hypertension Treatment Strategy Among PAD Patients; page unavailable) compare antihypertensive strategies, not racial or ethnic groups. Searches for racial and ethnic disparities, revascularization, and the 1990s found no passage documenting the claimed disparity or its history. (LLM, conf=0.76)
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- Authors
- Bavry, A. A., Anderson, R. D., Gong, Y., Denardo, S. J., Cooper-DeHoff, R. M., Handberg, E. M., & Pepine, C. J.
- Affiliations
- University of Florida (US)
- From the Division of Cardiovascular Medicine, College of Medicine (A.A.B., R.D.A., S.J.D., R.M.C.-D., E.M.H., C.J.P.), and Department of Pharmacotherapy and Translational Research, College of Pharmacy (Y.G., R.M.C.-D.), University of Florida, Gainesville, Fla.
- ORCID
- Venue
- Hypertension
- Published
- 2010-01
- Volume
- 55
- Issue
- 1
- Pages
- 48-53
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- PMC
- PMC3000120
- OpenAlex
- W2019678113
- Semantic Scholar
- 902882d2b6ece6b530f147192a35483f0cc6b00a
- Cited by
- 188
- References
- 31
- Citations by year
- 2026: 7 · 2025: 5 · 2024: 15 · 2023: 16 · 2022: 10 · 2021: 22 · 2020: 14 · 2019: 15 · 2018: 16 · 2017: 15 · 2016: 7 · 2015: 2 · 2014: 5 · 2013: 7 · 2012: 10
- FWCI
- 6.90
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Hypertension (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (K23HL086558)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Surgery › Peripheral Artery Disease Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Keywords
- peripheral arterial disease, coronary artery disease, blood pressure targets, systolic blood pressure, J-shaped relationship, cardiovascular outcomes, all-cause mortality, myocardial infarction, stroke, antihypertensive therapy
- MeSH terms
- Adrenergic beta-Antagonists, Aged, Angiotensin-Converting Enzyme Inhibitors, Antihypertensive Agents, Aspirin, Blood Pressure, Coronary Artery Disease, Female, Follow-Up Studies, Humans, Hypertension, Male, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Peripheral Vascular Diseases, Outcome Assessment, Health Care, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Angiotensin II Type 1 Receptor Blockers, Kaplan-Meier Estimate
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