Importance of a history of hypertension for the prognosis after acute myocardial infarction--for the Bucindolol Evaluation in Acute myocardial infarction Trial (BEAT) study group.
BACKGROUND
Arterial hypertension is a major risk factor for cardiovascular events. The prognosis for hypertensive patients after acute myocardial infarction (MI) is uncertain because of the sparse and somewhat contradictionary data.


OBJECTIVE
Our study aimed to investigate the importance of hypertension to prognosis after an MI in patients receiving contemporary medical therapy.


METHODS
We performed a retrospective study using a large register from the Bucindolol Evaluation in Acute myocardial infarction Trial (BEAT). The register comprised 3,326 patients admitted between June 1998 and August 1999 with an enzyme-verified MI to 33 Danish coronary care units. Hypertension was considered present when a previous diagnosis of hypertension was accompanied by relevant medical therapy. Survival information for all patients was obtained in January 2002.


RESULTS
Of the 3,326 patients studied, 825 were hypertensive. Overall, 28.4% had died by January 2002. The unadjusted hazard ratio associated with hypertension was 1.2 (95% confidence limit [CI] 1.1-1.4, p = 0.004). Hypertensive patients were older, and after adjustment for age the hazard ratio associated with hypertension was 1.04 (CI 0.9-1.2, p = 0.6). Adjustment for further covariates did not change the result.


CONCLUSIONS
Our study showed that after an acute MI the survival rate of patients with and without a history of hypertension was identical when they received contemporary medical therapy.
Ali
Irma
I
Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark.
Akman
Dilek
D
Bruun
Niels Eske
NE
Køber
Lars
L
Brendorp
Bente
B
Ottesen
Michael
M
Møller
Jacob
J
Torp-Pedersen
Christian
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy / Q000401:mortality*; D011379:Prognosis; D011412:Propanolamines / Q000627:therapeutic use; D012042:Registries / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D014665:Vasodilator Agents / Q000627:therapeutic use
D011412:Propanolamines; D014665:Vasodilator Agents; C024307:bucindolol