Clinical Effects of Hypertension on the Mortality of Patients with Acute Myocardial Infarction
Authors
Dong Goo Kang ; Myung Ho Jeong ; Yongkeun Ahn ; Shung Chull Chae ; Seung Ho Hur ; Taek Jong Hong ; Young Jo Kim ; In Whan Seong ; Jei Keon Chae ; Jay Young Rhew ; In Ho Chae ; Myeong Chan Cho ; Jang Ho Bae ; Seung Woon Rha ; Chong Jin Kim ; Yang Soo Jang ; Junghan Yoon ; Ki Bae Seung ; Seung Jung Park
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.24(5) : 800-806, 2009
The incidence of ischemic heart disease has been increased rapidly in Korea. However, the clinical effects of antecedent hypertension on acute myocardial infarction have not been identified. We assessed the relationship between antecedent hypertension and clinical outcomes in 7,784 patients with acute myocardial infarction in the Korea Acute Myocardial Infarction Registry during one-year follow-up. Diabetes mellitus, hyperlipidemia, cerebrovascular disease, heart failure, and peripheral artery disease were more prevalent in hypertensives (n=3,775) than nonhypertensives (n=4,009). During hospitalization, hypertensive patients suffered from acute renal failure, shock, and cerebrovascular event more frequently than in nonhypertensives. During follow-up of one-year, the incidence of major adverse cardiac events was higher in hypertensives. In multi-variate adjustment, old age, Killip class > or =III, left ventricular ejection fraction <45%, systolic blood pressure <90 mmHg on admission, post procedural TIMI flow grade < or =2, female sex, and history of hypertension were independent predictors for in-hospital mortality. However antecedent hypertension was not significantly associated with one-year mortality. Hypertension at the time of acute myocardial infarction is associated with an increased rate of in-hospital mortality.