Influence of mild to moderate treated hypertension on 9-11 year mortality in patients with pre-existing coronary heart disease.

Hypertension is a known risk factor in the genesis of coronary artery disease. However, the effect of pre-existing hypertension on the long-term mortality in patients with established coronary heart disease is not clear. The present cohort study analysed the influence of baseline mild to moderate treated hypertension in cases of known coronary heart disease with cardiac mortality as end point. Data from a cohort of 511 patients including 266 normotensives and 245 controlled hypertensives was analysed over a follow-up period of 9 to 11 years. The baseline data were identical regarding other major risk factors like age, gender, smoking, diabetes, cholesterol levels and congestive heart failure on univariate analysis. There were more cases of myocardial infarction in the normotensive group. The number of patients receiving beta-blockers or aspirin were similar in both groups. However, more patients in the hypertensive group received nifedipine. Actuarial analysis of survival showed that mortality was the same in both groups with an overall cardiac mortality of 65 (26.5%) in the hypertensive group and 86 (32.3%) in the normotensive group (P greater than 0.1). The survival curves also showed no significant difference in mortality at any point in time (logrank test = 2.37, P greater than 0.1). Analysis of mortality after adjusting for myocardial infarction at first presentation also showed no significant difference. These data indicate that in patients with coronary heart disease the presence of mild to moderate hypertension does not add to the risk of cardiac mortality.