Evidence map›Paper›PMID 23720247›Full record

Trial reportClinical cardiology2013

Mortality implications of angina and blood pressure in hypertensive patients with coronary artery disease: New data from extended follow-up of the International Verapamil/Trandolapril Study (INVEST).

David E Winchester, Rhonda M Cooper-Dehoff, Yan Gong, Eileen M Handberg, Carl J Pepine, INVEST Investigators

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Clinical cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

David E WinchesterDivision of Cardiovascular Medicine, College of Medicine, University of Florida, Gainesville, Florida.
Rhonda M Cooper-Dehoff
Yan Gong
Eileen M Handberg
Carl J Pepine
INVEST Investigators

Funding

UF Clinical and Translational Science AwardUL1TR000064 · NCATS · UNIVERSITY OF FLORIDA · PI NELSON, DAVID R · 2012 to 2014
$12.2M
Metabolic Effects of Antihypertensive DrugsK23HL086558 · NHLBI · UNIVERSITY OF FLORIDA · PI COOPER-DEHOFF, RHONDA M · 2007 to 2011
$672k
NCATS NIH HHS UL1 TR000064NCATS NIH HHS UL1TR000064NHLBI NIH HHS K23 HL086558NHLBI NIH HHS K23HL086558
6 · The paper itself

Abstract

backgroundAngina and hypertension are common in patients with coronary artery disease (CAD); however, the effect on mortality is unclear. We conducted this prespecified analysis of the International Verapamil/Trandolapril Study (INVEST) to assess relationships between angina, blood pressure (BP), and mortality among elderly, hypertensive CAD patients. HYPOTHESIS: Angina and elevated BP will be associated with higher mortality.

methodsExtended follow-up was performed using the National Death Index for INVEST patients in the United States (n = 16 951). Based on angina history at enrollment and during follow-up visits, patients were divided into groups: persistent angina (n = 7184), new-onset angina (n = 899), resolved angina (n = 4070), and never angina (n = 4798). Blood pressure was evaluated at baseline, during drug titration, and during follow-up on-treatment. On-treatment systolic BP was classified as tightly controlled (<130 mm Hg), controlled (130-139 mm Hg), or uncontrolled (≥140 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 BP control groups were compared using the never-angina group as the reference.

resultsOnly in the persistent-angina group was a significant association with mortality observed, with an apparent protective effect (hazard ratio: 0.82, 95% confidence interval: 0.75-0.89, P < 0.0001). Uncontrolled BP was associated with increased mortality risk (hazard ratio: 1.29, 95% confidence interval: 1.20-1.40, P < 0.0001), as were several other known cardiovascular risk factors.

conclusionsIn hypertensive CAD patients, persistent angina was associated with lower mortality. The observed effect was small compared with other cardiovascular risk factors, such as BP, which were associated with increased mortality.

Indexed as

AgedAge FactorsAngina PectorisAngiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsBlood PressureCalcium Channel BlockersChi-Square DistributionCoronary Artery DiseaseFemaleHumansHypertensionIndolesKaplan-Meier EstimateMaleMiddle AgedAngiotensin-Converting Enzyme InhibitorsAntihypertensive AgentsCalcium Channel BlockersIndolestrandolaprilVerapamil

Identifiers

PMID23720247
PMCPMC3775918

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.