{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,2]],"date-time":"2025-11-02T10:29:53Z","timestamp":1762079393721},"reference-count":36,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,5,29]],"date-time":"2013-05-29T00:00:00Z","timestamp":1369785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Angina and hypertension are common in patients with coronary artery disease (<jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>); however, the effect on mortality is unclear. We conducted this prespecified analysis of the International Verapamil\/Trandolapril Study (<jats:styled-content style=\"fixed-case\">INVEST<\/jats:styled-content>) to assess relationships between angina, blood pressure (<jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>), and mortality among elderly, hypertensive <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content> patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>Angina and elevated <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> will be associated with higher mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Extended follow\u2010up was performed using the National Death Index for <jats:styled-content style=\"fixed-case\">INVEST<\/jats:styled-content> patients in the United States (n = 16\u2009951). Based on angina history at enrollment and during follow\u2010up visits, patients were divided into groups: persistent angina (n = 7184), new\u2010onset angina (n = 899), resolved angina (n = 4070), and never angina (n = 4798). Blood pressure was evaluated at baseline, during drug titration, and during follow\u2010up on\u2010treatment. On\u2010treatment systolic <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> was classified as tightly controlled (&lt;130 mm Hg), controlled (130\u2013139 mm Hg), or uncontrolled (\u2265140 mm Hg). A Cox proportional hazards model was created adjusting for age, heart failure, diabetes, renal impairment, myocardial infarction, stroke, and smoking. The angina groups and <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> control groups were compared using the never\u2010angina group as the reference.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only in the persistent\u2010angina group was a significant association with mortality observed, with an apparent protective effect (hazard ratio: 0.82, 95% confidence interval: 0.75\u20100.89, <jats:italic>P<\/jats:italic> &lt; 0.0001). Uncontrolled <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> was associated with increased mortality risk (hazard ratio: 1.29, 95% confidence interval: 1.20\u20101.40, <jats:italic>P<\/jats:italic> &lt; 0.0001), as were several other known cardiovascular risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In hypertensive <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content> patients, persistent angina was associated with lower mortality. The observed effect was small compared with other cardiovascular risk factors, such as <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>, which were associated with increased mortality.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22145","type":"journal-article","created":{"date-parts":[[2013,5,29]],"date-time":"2013-05-29T14:02:35Z","timestamp":1369836155000},"page":"442-447","source":"Crossref","is-referenced-by-count":6,"title":["Mortality Implications of Angina and Blood Pressure in Hypertensive Patients With Coronary Artery Disease: New Data From Extended Follow\u2010up of the International Verapamil\/Trandolapril Study (<scp>INVEST<\/scp>)"],"prefix":"10.1002","volume":"36","author":[{"given":"David E.","family":"Winchester","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine College of Medicine, University of Florida  Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rhonda M.","family":"Cooper\u2010DeHoff","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine College of Medicine, University of Florida  Gainesville Florida"},{"name":"Department of Pharmacotherapy and Translational Research College of Pharmacy, University of Florida  Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Pharmacotherapy and Translational Research College of Pharmacy, University of Florida  Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eileen M.","family":"Handberg","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine College of Medicine, University of Florida  Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl J.","family":"Pepine","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine College of Medicine, University of Florida  Gainesville Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the INVEST Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2013,5,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.109.142240"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16980-8"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2009.1649"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.12.1404"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(72)90624-8"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2006.090118"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.1998.00394.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2008.146944"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2004.057703"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-122-2-199501150-00003"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.107.183885"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.21.2805"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/clc.20501"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2010.884"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(02)11911-8"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38603.656076.63"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38695.605440.AE"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)00279-9"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-144-12-200606200-00005"},{"key":"e_1_2_6_21_1","first-page":"1","article-title":"Deaths: final data for 2006","volume":"57","author":"Heron M","year":"2009","journal-title":"Natl Vital Stat Rep."},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.09.023"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.293.4.477"},{"key":"e_1_2_6_24_1","unstructured":"AndersonRD PepineCJ. 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