Comparison of patients with acute coronary syndrome with and without systemic hypertension. Am J Cardiol 2003 Aug 01;92(3):258-63
Date
07/31/2003Pubmed ID
12888127DOI
10.1016/s0002-9149(03)00620-9Scopus ID
2-s2.0-0042347543 (requires institutional sign-in at Scopus site) 33 CitationsAbstract
The role of systemic hypertension in acute coronary syndrome (ACS) has not been well studied. We studied consecutive subjects admitted to the University of Michigan Health System (Ann Arbor, Michigan) with symptoms of ACS. Data were collected using a standardized form. This observational study is currently ongoing; we collected data from May 1999 to December 2000 for 979 subjects, 890 of whom also had 6-month follow-up data. Hypertensives represented 64.4% (n = 630) of the total population. In general, hypertensive patients were older than normotensives (66.3 vs 59.9 years, p <0.0001), more often women (38.7% vs 26.9%, p = 0.0002), and had more comorbidities, such as previous myocardial infarction (47.9% vs 33.8%, p <0.0001), congestive heart failure (25.7% vs 12.0%, p <0.0001), and diabetes (36.9% vs 17.8%, p <0.0001). At admission, hypertensives had higher systolic blood pressure. Hypertensives had fewer electrocardiographic abnormalities indicating ischemic changes (67.9% vs 76.3%, p = 0.01) and had fewer incident of acute myocardial infarction (AMI) (70.7% vs 76.1%, p = 0.07) than normotensives. There was consistency over different levels of admission systolic blood pressure. Hypertensives received more oral cardiovascular drugs, and had undergone more invasive procedures. The lower rate of AMI in hypertensives seemed to be related to the higher frequency of a history of percutaneous coronary intervention and coronary artery bypass grafting. However, at 6-month follow-up, age- and gender-adjusted odds ratios for adverse events were equivalent in hypertensives and normotensives, suggesting no continuing differential treatment benefit for hypertensives in the months after the initial ACS episode.
Author List
Majahalme SK, Smith DE, Cooper JV, Kline-Rogers E, Mehta RH, Eagle KA, Bisognano JDAuthor
Silja Majahalme MD, PhD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Acute DiseaseAge Distribution
Aged
Biomarkers
Cardiovascular Agents
Comorbidity
Coronary Disease
Creatine Kinase
Electrocardiography
Female
Follow-Up Studies
Humans
Hypertension
Male
Michigan
Middle Aged
Myocardial Infarction
Odds Ratio
Reference Values
Regression Analysis
Sex Distribution
Syndrome
Troponin I
