Abstract 14414: Treated Hypertension and Risk For Cardiovascular Events in Women: The NHLBI-Sponsored Women's Ischemia Syndrome Evaluation (WISE)
Objectives. We previously demonstrated that women with suspected CAD often fail to be treated for dyslipidemia. Using new extended follow-up data, we report the prognosis for CV events in women relative to treatment of hypertension.
Methods. We prospectively followed 932 women referred for coronary angiography for symptoms of myocardial ischemia, through annual contacts for a median of 5.9 years. This was followed by a National Death Index search that extended the follow-up period to a median of 9.5 years. Death certificates and/or physician narrative were obtained in the case of death and the WISE mortality committee adjudicated all deaths as cardiovascular (CV) or non-CV. An adverse CV event was defined as non-fatal MI, heart failure, stroke and/or CV death. Hypertension (HTN+) was defined using 2007 AHA guidelines for patients with stable angina (>130/80 mmHg). The women were classified into 4 groups (1) no HTN (HTN-) and no use at baseline of HTN meds (Rx-) (n=216); (2) HTN+ and Rx- (n=442); (3) HTN- and Rx+ (n=89); (4) HTN+ and Rx+ (n=185).
Results. Mean age was 58±12 years and 197 (21%) had a CV event (115 CV deaths). Group 1 had the fewest events (reference group). Groups 2 and 3 had similar event rates that were higher than Group 1 (p=0.002). Group 4 having the worst prognosis (p=0.002) (figure). Adjustment for age and presence of obstructive CAD (>50% stenosis) did not alter the findings.
Conclusions. Among women undergoing coronary angiography with signs and symptoms of ischemia, HTN frequently failed to be treated. Women with suspected ischemia and un-/undertreated HTN have a poor prognosis, independent of age and CAD.
- © 2011 by American Heart Association, Inc.