Hypertension control at hospital discharge after acute coronary event: influence on cardiovascular prognosis--the PREVENIR study.
OBJECTIVE
To assess hypertension control in patients admitted to hospital for an acute coronary event and to investigate the influence on prognosis of controlling hypertension before hospital discharge.


METHODS
Multicentre retrospective cohort study.


METHODS
The medical records were examined of all patients admitted in 77 cardiological centres on January 1998 for myocardial infarction or unstable angina and who survived. Clinical characteristics, blood pressure at hospital discharge, and cardiovascular events during a six month follow up were recorded.


METHODS
Cardiovascular deaths and non-fatal myocardial infarction.


RESULTS
Data were available in 1247 patients. At discharge, 411 (32.9%) had uncontrolled hypertension; among these, 276 (22.1%) were uncontrolled on the basis of systolic blood pressure alone. Forty three cardiovascular deaths and 20 non-fatal myocardial infarcts occurred during follow up. In a multivariate analysis, age, left ventricular ejection fraction, previous history of cardiovascular disease, and isolated systolic hypertension (odds ratio 1.9, 95% confidence interval 1.07 to 3.37) were associated with the outcome.


CONCLUSIONS
22.1% of patients admitted to hospital for an acute coronary syndrome have uncontrolled isolated systolic hypertension on discharge. This appears to be an independent predictor of cardiovascular outcome.
Amar
J
J
Service de Médecine et d'Hypertension Artérielle, CHU Purpan, Toulouse, France. amar.j@chu-toulouse.fr
Chamontin
B
B
Ferriéres
J
J
Danchin
N
N
Grenier
O
O
Cantet
C
C
Cambou
J-P
JP
D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000503:physiopathology / Q000628:therapy*; D001794:Blood Pressure / Q000502:physiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000503:physiopathology / Q000628:therapy*; D010351:Patient Discharge; D011379:Prognosis; D012189:Retrospective Studies