Medicinski Glasnik (Feb 2009)
The influence of hypertension on in-hospital outcome in patients with acute myocardial infarction
Abstract
Aim To examine the differences in the frequency of risk factors,clinical presentations on admission and in-hospital outcome in hypertensiveand normotensive patients treated for acute myocardialinfarction (AMI).Methods In hypertensive and normotensive patients with AMI weretrospectively analyzed risk factors (age, gender, smoking habits,diabetes, blood lipids, history of angina pectoris, previous myocardialinfarction, previous stroke and family history of atherothromboticdisease), admission Killip class, localization of AMI, and inhospitaloutcome. For group comparisons we used Student’s t-testand χ² test. Values of p<0.05 were considered significant.Results Out of 396 consecutive patients with AMI, 147 (37.1%)patients were women and 249 (62.9%) were men. Comparing tomen, women presented more frequently with hypertension (55.1%vs. 42.6% for men, respectively). Hypertensive patients had smokinghabits (16.6% vs. 26.8%) and previous myocardial infarction(2.1% vs. 7.7%) less frequently than normotensive patients. Normotensivepatients had history of angina pectoris less frequently(12.0% vs. 21.4%). We did not find any significant differences inpresence of other risk factors or admission Killip class. Normotensivepatients had inferior AMI more frequently (35.9% vs. 25.7%).In-hospital mortality was significantly higher in normotensive patients(24.9% vs. 15.0%), and this difference persists after strati-fied analysis according to gender (16.8% vs. 7.5% for men; 42.4%vs. 24.7% for women).Conclusion Hypertensive patients with AMI have better in-hospitaloutcome than normotensive patients. It is not sufficient toanalyze risk factors, clinical presentations on admission of patientswith AMI stratified by hypertension status to accurately predict theearly outcome.
