Clinical Effects of Hypertension on the Mortality of Patients with Acute Myocardial Infarction
Dong Goo Kang,1Myung Ho Jeong,2Yongkeun Ahn,2Shung Chull Chae,3Seung Ho Hur,4Taek Jong Hong,5Young Jo Kim,6In Whan Seong,7Jei Keon Chae,8Jay Young Rhew,9In Ho Chae,10Myeong Chan Cho,11Jang Ho Bae,12Seung Woon Rha,13Chong Jin Kim,14Yang Soo Jang,15Junghan Yoon,16Ki Bae Seung,17Seung Jung Park,18
and Korea Acute Myocardial Infarction Registry Investigators
1Kwangju Christian Hospital, Gwangju, Korea.
2Chonnam National University, Gwangju, Korea.
3Kyungpook National University, Daegu, Korea.
4Keimyung University Dongsan Medical Center, Daegu, Korea.
5Pusan National University Hospital, Busan, Korea.
6Yeungnam University Hospital, Daegu, Korea.
7Chungnam National University Hospital, Daejeon, Korea.
8Chonbuk National University Hospital, Jeonju, Korea.
9Jeonju Presbyterian Medical Center, Jeonju, Korea.
10Seoul National University Bundang Hospital, Seongam, Korea.
11Chungbuk National University, Cheongju, Korea.
12Konyang University, Daejon, Korea.
13Korea University Guro Hospital, Seoul, Korea.
14Kyunghee University Hospital, Seoul, Korea.
15Yonsei University Severance Hospital, Seoul, Korea.
16Wonju University Hospital, Wonju, Korea.
17Catholic University of Seoul St. Mary's Hospital, Seoul, Korea.
18Asan Medical Center, University of Ulsan, Seoul, Korea.
Address for correspondence: Myung Ho Jeong, M.D. The Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, 8 Hak-dong, Dong-gu, Gwangju 501-757, Korea. Tel: +82.62-220-6243, Fax: +82.62-228-7174, Email: myungho@chollian.net
* Korea Acute Myocardial Infarction Registry (KAMIR) Investigators: Myung Ho Jeong, Young Jo Kim, Chong Jin Kim, Myeong Chan Cho, Young Keun Ahn, Jong Hyun Kim, Shung Chull Chae, Seung Ho Hur, In Whan Seong, Taek Jong Hong, Dong Hoon Choi, Jei Keon Chae, Jae Young Rhew, Doo Il Kim, In Ho Chae, Jung Han Yoon, Bon Kwon Koo, Byung Ok Kim, Myoung Yong Lee, Kee Sik Kim, Jin Yong Hwang, Seok Kyu Oh, Nae Hee Lee, Kyoung Tae Jeong, Seung Jea Tahk, Jang Ho Bae, Seung Woon Rha, Keum Soo Park, Kyoo Rok Han, Tae Hoon Ahn, Moo Hyun Kim, Ju Young Yang, Chong Yun Rhim, Hyeon Cheol Gwon, Seong Wook Park, Young Youp Koh, Seung Jae Joo, Soo Joong Kim, Dong Kyu Jin, Jin Man Cho, Jeong Gwan Cho, Wook Sung Chung, Yang Soo Jang, Ki Bae Seung, and Seung Jung Park.
Received July 04, 2008; Accepted November 22, 2008.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
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 ≥III, left ventricular ejection fraction <45%, systolic blood pressure <90 mmHg on admission, post procedural TIMI flow grade ≤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.
Lewis EF,Moye LA,Rouleau JL,Sacks FM,Arnold JM,Warnica JW,Flaker GC,Braunwald E,Pfeffer MA. CARE Study. Predictors of late development of heart failure in stable survivors of myocardial infarction: the CARE study. J Am Coll Cardiol 2003;42:1446–1453.
2.
Richards AM,Nicholls MG,Troughton RW,Lainchbury JG,Elliott J,Frampton C,Espiner EA,Crozier IG,Yandle TG,Turner J. Antecedent hypertension and heart failure after myocardial infarction. J Am Coll Cardiol 2002;39:1182–1188.
3.
Witt BJ,Ballman KV,Brown RD Jr,Meverden RA,Jacobsen SJ,Roger VL. The incidence of stroke after myocardial infarction: a meta-analysis. Am J Med 2006;119:354.e1–354.e9.
4.
Miura K,Daviglus ML,Dyer AR,Liu K,Garside DB,Stamler J,Greenland P. Relationship of blood pressure to 25-year mortality due to coronary heart disease, cardiovascular diseases, and all causes in young adult men: The Chicago Heart Association Detection Project in Industry. Arch Intern Med 2001;161:1501–1508.
5.
Lewington S,Clarke R,Qizilbash N,Peto R,Collins R. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903–1913.
6.
Willich SN,Müller-Nordhorn J,Kulig M,Binting S,Gohlke H,Hahmann H,Bestehorn K,Krobot K,Völler H. PIN Study Group. Cardiac risk factors, medication, and recurrent clinical events after acute coronary disease; a prospective cohort study. Eur Heart J 2001;22:307–313.
7.
Piegas LS,Avezum A,Pereira JC,Neto JM,Hoepfner C,Farran JA,Ramos RF,Timerman A,Esteves JP. AFIRMAR Study Investigators. Risk factors for myocardial infarction in Brazil. Am Heart J 2003;146:331–338.
8.
Yusuf S,Hawken S,Ounpuu S,Dans T,Avezum A,Lanas F,Mc-Queen M,Budaj A,Pais P,Varigos J,Lisheng L. INTERHEART Study Investigators. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet 2004;364:937–952.
9.
Richards AM,Nicholls MG,Troughton RW,Lainchbury JG,Elliott J,Frampton C,Espiner EA,Crozier IG,Yandle TG,Turner J. Antecedent hypertension and heart failure after myocardial infarction. J Am Coll Cardiol 2002;39:1182–1188.
10.
Thune JJ,Signorovitch J,Kober L,Velazquez EJ,McMurray JJ,Califf RM,Maggioni AP,Rouleau JL,Howlett J,Zelenkofske S,Pfeffer MA,Solomon SD. Effect of antecedent hypertension and follow-up blood pressure on outcomes after high-risk myocardial infarction. Hypertension 2008;51:48–54.
11.
Rakugi H,Yu H,Kamitani A,Nakamura Y,Ohishi M,Kamide K,Nakata Y,Takami S,Higaki J,Ogihara T. Links between hypertension and myocardial infarction. Am Heart J 1996;132:213–221.
12.
Korea Acute Myocardial Infarction Registry (KAMIR) Investigators; Lee KH,Jeong MH,Ahn YK,Kim JH,Chae SC,Kim YJ,Hur SH,Seong IW,Hong TJ,Choi D,Cho MC,Kim CJ,Seung KB,Chung WS,Jang YS,Cho JG,Park SJ. Other Korea Acute Myocardial Infarction Registry Investigators. Gender differences of success rate of percutaneous coronary intervention and short term cardiac events in Korea Acute Myocardial Infarction Registry. Int J Cardiol 2008;130:227–234.
13.
Lee SR,Jeong MH,Ahn YK,Chae SC,Hur SH,Kim YJ,Seong IW,Chae JK,Hong TJ,Rhew JY,Cho MC,Bae JH,Rha SW,Kim CJ,Jang YS,Park SJ. Korea Acute Myocardial Infarction Registry Investigators. Clinical safety of drug-eluting stents in the Korea acute myocardial infarction registry. Circ J 2008;72:392–398.
14.
Pastor-Barriuso R,Banegas JR,Damian J,Appel LJ. Systolic blood pressure, diastolic blood pressure, and pulse pressure: an evaluation of their joint effect on mortality. Ann Intern Med 2003;139:731–739.
15.
Sipahi I,Tuzcu EM,Schoenhagen P,Wolski KE,Nicholls SJ,Balog C,Crowe TD,Nissen SE. Effects of normal, pre-hypertensive, and hypertensive blood pressure levels on progression of coronary atherosclerosis. J Am Coll Cardiol 2006;48:833–838.
16.
Kenchaiah S,Davis BR,Braunwald E,Rouleau JL,Dagenais GR,Sussex B,Steingart RM,Brown EJ Jr,Lamas GA,Gordon D,Bernstein V,Pfeffer MA. Survival and Ventricular Enlargement Trial. Antecedent hypertension and the effect of captopril on the risk of adverse cardiovascular outcomes after acute myocardial infarction with left ventricular systolic dysfunction: Insights from the Survival and Ventricular Enlargement Trial. Am Heart J 2004;148:356–364.
17.
Kuulasmaa K,Tunstall-Pedoe H,Dobson A,Fortmann S,Sans S,Tolonen H,Evans A,Ferrario M,Tuomilehto J. Estimation of contribution of changes in classic risk factors to trends in coronary-event rates across the WHO MONICA Project populations. Lancet 2000;355:675–687.
18.
Ford ES,Ajani UA,Croft JB,Critchley JA,Labarthe DR,Kottke TE,Giles WH,Capewell S. Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. N Engl J Med 2007;356:2388–2398.
19.
Khor GL. Cardiovascular epidemiology in the Asia-Pacific region. Asia Pac J Clin Nutr 2001;10:76–80.
20.
Ko M,Kim MT,Nam JJ. Assessing risk factors of coronary heart disease and its risk prediction among Korean adults: the 2001 Korea National Health and Nutrition Examination Survey. Int J Cardiol 2006;110:184–190.
21.
Majahalme SK,Smith DE,Cooper JV,Kline-Rogers E,Mehta RH,Eagle KA,Bisognano JD. Comparison of patients with acute coronary syndrome with and without systemic hypertension. Am J Cardiol 2003;92:258–263.
22.
Mehta RH,Roe MT,Chen AY,Lytle BL,Pollack CV Jr,Brindis RG,Smith SC Jr,Harrington RA,Fintel D,Fraulo ES,Califf RM,Gibler WB,Ohman EM,Peterson ED. Recent trends in the care of patients with non-ST-segment elevation acute coronary syndromes: insights from the CRUSADE initiative. Arch Intern Med 2006;166:2027–2034.
23.
Keeley EC,Boura JA,Grines CL. Primary angioplasty versus intra venous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet 2003;361:13–20.
24.
Song YB,Hahn JY,Gwon HC,Kim JH,Lee SH,Jeong MH. KAMIR investigators. The impact of initial treatment delay using primary angioplasty on mortality among patients with acute myocardial infarction: from the Korea Acute Myocardial Infarction Registry. J Korean Med Sci 2008;23:357–364.
25.
Mauri F,Maggioni AP,Franzosi MG,de Vita C,Santoro E,Santoro L,Giannuzzi P,Tognoni G. A simple electrocardiographic predictor of the outcome of patients with acute myocardial infarction treated with a thrombolytic agent. A Gruppo Italiano per lo Studio della Sopravvivenza nell' Infarto Miocardico (GISSI-2)-Derived Analysis. J Am Coll Cardiol 1994;24:600–607.
26.
Devereux RB,Roman MJ. Inter-relationships between hypertension, left ventricular hypertrophy and coronary heart disease. J Hypertens 1993;11 Suppl:S3–S9.
27.
Herlitz J,Bång A,Karlson BW. Five-year prognosis after acute myocardial infarction in relation to a history of hypertension. Am J Hypertens 1996;9:70–76.
28.
Yagi M,Nakao K,Honda T,Tsurumi Y,Kasanuki H. Clinical characteristics and early outcomes of very elderly patients in the reperfusion era. Int J Cardiol 2004;94:41–46.
29.
White HD,Aylward PE,Huang Z,Dalby AJ,Weaver WD,Barvik S,Marin-Neto JA,Murin J,Nordlander RO,van Gilst WH,Zannad F,McMurray JJ,Califf RM,Pfeffer MA. VALIANT Investigators. Mortality and morbidity remain high despite captopril and/or Valsartan therapy in elderly patients with left ventricular systolic dysfunction, heart failure, or both after acute myocardial infarction: results from the Valsartan in Acute Myocardial Infarction Trial (VALIANT). Circulation 2005;112:3391–3399.
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