Influence of Hispanic ethnicity on blood pressure control and cardiovascular outcomes in women with CAD and hypertension: findings from INVEST

J Womens Health (Larchmt). 2007 Jun;16(5):632-40. doi: 10.1089/jwh.2006.0086.

Abstract

Background: Prospective data regarding blood pressure (BP) control and cardiovascular (CV) outcomes in Hispanic women are lacking.

Methods: We analyzed 5017 Hispanic and 4710 non-Hispanic white hypertensive women with coronary artery disease (CAD) in the INternational VErapamil SR/Trandolapril STudy (INVEST) to determine the impact of baseline characteristics and BP control on CV outcomes.

Results: At baseline, Hispanic women were younger and a had lower prevalence of most established CV risk factors than non-Hispanic white women. At 24 months, BP control (< 140/90 mm Hg) was achieved in 75% of Hispanic and 68% of non-Hispanic white women, (p < 0.001), with most women, regardless of ethnicity, requiring > or =2 antihypertensive agents. Following 26,113 patient-years of follow-up, the primary outcome (first occurrence of nonfatal myocardial infarction [MI], nonfatal stroke, or all cause death) occurred in 5.7% of Hispanic and 12.3% of non-Hispanic white women (adjusted HR = 0.84, 95% CI = 0.71-0.98, p = 0.03). There was no difference in outcome in either group of women comparing the randomized antihypertensive treatment strategies.

Conclusions: Despite accounting for a lower risk profile, deployment of protocol-based antihypertensive treatment regimens resulted in superior BP control and fewer CV events in Hispanic women compared with non-Hispanic white women.

Publication types

  • Controlled Clinical Trial
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antihypertensive Agents / therapeutic use*
  • Blood Pressure / drug effects
  • Confidence Intervals
  • Coronary Artery Disease / drug therapy*
  • Coronary Artery Disease / epidemiology
  • Coronary Artery Disease / ethnology*
  • Female
  • Follow-Up Studies
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Hydrochlorothiazide / therapeutic use
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Hypertension / ethnology*
  • Indoles / therapeutic use
  • Middle Aged
  • Odds Ratio
  • Proportional Hazards Models
  • Treatment Outcome
  • White People / statistics & numerical data*
  • Women's Health

Substances

  • Antihypertensive Agents
  • Indoles
  • Hydrochlorothiazide
  • trandolapril