Abstract 2758: Association of Systolic Blood Pressure (SBP) and Health Related Quality of Life in Patients with Coronary Artery Disease: An Analysis from the INternational VErapamil SR trandolapril STudy (INVEST)
PURPOSE: To investigate the association of SBP and other patient conditions with self-reported health related quality of life (HRQOL) in hypertensive patients with coronary artery disease (CAD).
METHODS: This study included 22,576 hypertensive CAD patients in INVEST, randomized to either a verapamil SR-tandolapril or atenolol-HCTZ based treatment strategy. At each study visit, before SBP was taken, patients rated their general health-related quality of life (HRQOL) status as excellent, good, fair, or poor. The outcome measure was adverse HRQOL defined as feeling ‘Fair’ or ‘Poor’ or feeling worse than at study entry. Logistic regression was performed to assess the association between probability of reporting adverse HRQOL and SBP at each visit controlling for confounding factors found significantly associated with adverse HRQOL.
RESULTS: Odds ratios (OR) for reporting adverse HRQOL are summarized in the figure⇓, with SBP≤120 mmHg as the reference group. At all study visits, patients with higher SBP were progressively more likely to report an adverse HRQOL. Specifically, after controlling for confounding factors, at 6 weeks and 2 years, patients with SBP > 160 mmHg were ~2.5 times (OR: 2.42, 95% confidence interval [2.12–2.76]) and ~3 times (2.90, [2.44–3.45]) more likely to report adverse HRQOL than patients with SBP≤ 120 mmHg, respectively. Angina, higher BMI, smoking, female gender and diabetes were also associated with adverse HRQOL.
CONCLUSIONS: Among hypertensive CAD patients, SBP level during treatment is strongly and independently associated with adverse HRQOL.