The prevalence and outcome of hypertension in patients with acute coronary syndrome in six Middle-Eastern countries.
OBJECTIVE
The aim was to report the prevalence and significance of hypertension (HTN) in patients with acute coronary syndrome (ACS).


RESULTS
Over a 6-month period in 2007, 8171 consecutive patients (49.4% hypertensive and 50.6% non-hypertensive) presenting with ACS were enrolled in a prospective, multicenter study from six Middle Eastern adjacent countries. Patients with HTN were older (59.2 vs 53.1 years, p<0.001), and more likely to be female (34% vs 14.4%, p<0.001) when compared with patients without HTN. Patients with HTN were also more likely to have diabetes mellitus, hyperlipidemia, cerebrovascular disease, prior history of coronary artery disease, peripheral artery disease but less likely to be cigarette smokers. At admission, HTN patients had higher Killip class, heart rate and GRACE risk scoring. In-hospital mortality was higher in hypertensive patients with ST-elevation myocardial infarction (STEMI) but not in patients with non-STEMI or unstable angina. The incidence of heart failure complications was significantly higher among patients with HTN in overall ACS type (OR = 1.2, 95% CI 1.001-1.338, p= 0.04).


CONCLUSIONS
In this large cohort of patients with ACS, HTN was an independent predictor of heart failure and was associated with an increased rate of in-hospital mortality in STEMI only.
Ali
Waleed M
WM
Department of Cardiology, Hamad Medical Corporation (HMC), Qatar and Weill Cornell Medical College, Doha, Qatar.
Zubaid
Mohammad
M
El-Menyar
Ayman
A
Al Mahmeed
Wael
W
Al-Lawati
Jawad
J
Singh
Rajvir
R
Ridha
Mustafa
M
Al-Hamdan
Rashed
R
Alhabib
Khalid
K
Al Suwaidi
Jassim
J
D054058:Acute Coronary Syndrome / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D000367:Age Factors; D002561:Cerebrovascular Disorders / Q000150:complications; D048909:Diabetes Complications / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D008877:Middle East; D009203:Myocardial Infarction / Q000150:complications* / Q000453:epidemiology / Q000401:mortality / Q000628:therapy; D058729:Peripheral Arterial Disease / Q000150:complications; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016896:Treatment Outcome