西班牙高危患者的血压控制和心血管预后:来自INVEST(国际性维拉帕米缓释片/群多普利)研究的发现  

Blood pressure control and cardiovascular outcomes in high-risk Hispanic patients-Findings From the International Verapamil SR/Trandolapril Study(INVEST)

作　　者：Cooper-DeHoff R.M. Aranda Jr. J.M. Gaxiola E. 韩瑞娟 

机构地区：[1]University of Florida College of Medicine, Gainesville, FL, United States

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2006年第7期8-9,共2页

摘　　要：Background: People of Hispanic origin are the fastest growing ethnic minority in the United States and often have hypertension and other comorbidities which increase the risk associated with coronary artery disease(CAD). Methods and Results: An analysis of the 8045 Hispanic patients enrolled in INVEST was conducted, and comparisons were made to the 14 531 non-Hispanic patients. INVEST was a prospective, randomized, open, blinded end point study in CAD patients with hypertension. After 61 835 patient-years of follow-up, treatment with either a verapamil sustained release(SR) or atenolol antihypertensive strategy resulted in greater blood pressure control in Hispanic patients, and Hispanic patients were at significantly lower risk of experiencing a nonfatal myocardial infarction, nonfatal stroke, or death(hazard ratio[HR] 0.87, 95%CI 0.78-0.97). Hispanic ethnicity was associated with an increase(HR 1.19, 95%CI 1.04-1.36), and randomization to the verapamil SR strategy was associated with a decrease(HR 0.85, 95%CI 0.76-0.95), in the risk of new-onset diabetes. Use of trandolapril in the verapamil SR strategywas associated with reduced risk of new-onset diabetes, whereas increasing doses of atenolol and hydrochlorothiazide in the atenolol strategy were associated with increased risk of new-onset diabetes. Conclusions: The Hispanic cohort of INVEST had better blood pressure control and lower risk of adverse cardiovascular outcomes compared with the non-Hispanic cohort. A verapamil SR strategy is an alternative to an atenolol strategy for the treatment of Hispanic patients with hypertension and CAD and can reduce the risk of new-onset diabetes.Background: People of Hispanic origin are the fastest growing ethnic minority in the United States and often have hypertension and other comorbidities which increase the risk associated with coronary artery disease(CAD). Methods and Results: An analysis of the 8045 Hispanic patients enrolled in INVEST was conducted, and comparisons were made to the 14 531 non-Hispanic patients. INVEST was a prospective, randomized, open, blinded end point study in CAD patients with hypertension. After 61 835 patient-years of follow-up, treatment with either a verapamil sustained release(SR) or atenolol antihypertensive strategy resulted in greater blood pressure control in Hispanic patients, and Hispanic patients were at significantly lower risk of experiencing a nonfatal myocardial infarction, nonfatal stroke, or death(hazard ratio[HR] 0.87, 95%CI 0.78-0.97). Hispanic ethnicity was associated with an increase(HR 1.19, 95%CI 1.04-1.36), and randomization to the verapamil SR strategy was associated with a decrease(HR 0.85, 95%CI 0.76-0.95), in the risk of new-onset diabetes. Use of trandolapril in the verapamil SR strategywas associated with reduced risk of new-onset diabetes, whereas increasing doses of atenolol and hydrochlorothiazide in the atenolol strategy were associated with increased risk of new-onset diabetes. Conclusions: The Hispanic cohort of INVEST had better blood pressure control and lower risk of adverse cardiovascular outcomes compared with the non-Hispanic cohort. A verapamil SR strategy is an alternative to an atenolol strategy for the treatment of Hispanic patients with hypertension and CAD and can reduce the risk of new-onset diabetes.

关 键 词：群多普利 INVEST 维拉帕米 非致死性 抗高血压药物 新发糖尿病 阿替洛尔 风险降低 增长速度 

分 类 号：R54[医药卫生—心血管疾病]