Impact of high-normal blood pressure measured in emergency room on adverse cardiac events in acute myocardial infarction.
OBJECTIVE
Prehypertension according to JNC7 is common and is associated with increased vascular mortality. The importance of management in high-normal blood pressure (BP) is underemphasized.


METHODS
We analyzed major adverse cardiac events (MACEs) in the Korea Acute Myocardial Infarction Registry in normal BP (group I) and high-normal BP (group II) patients.


RESULTS
Among 14871 patients, 159 (61±12.3 years, 122 males) satisfied the study indication. Six-month and one-year clinical follow-up rate was 88.9% and 85.8%, respectively. Group I had 78 patients (60.9±12.4 years). Group II had 81 patients (61.6±12.5 years). Demographics of patients were not different between groups. Treatment strategy was not different. Initial Thrombolysis in Myocardial Infarction flow grade 0 was less frequent in group II (n=32, 47.1%) than in group I (n=16, 21.9%) (p=0.001). Successful intervention rate was not different between group II (93.8%) and group I (97.1%) (p=0.590). Six-month MACE occurred in 3 patients in group I (4.4%) and 10 in group II (15.6%) (p=0.031). Compared with normal BP, the odds ratio for patients with high-normal BP was 1.147 (p=0.045, 95% confidence interval 1.011-1.402) for 6-month MACE.


CONCLUSIONS
Even though high-normal BP patients had a better baseline clinical status, the prognosis was poorer than patients with normal BP. Therapeutic BP target goal for the patients with acute myocardial infarction should be <140/90 mm Hg, which is recommended in JNC7.
The Heart Center of Chonnam National University Hospital, Gwangju, Korea.
Nam Sik
NS
Yoon
Myung Ho
MH
Jeong
Youngkeun
Y
Ahn
Jong Hyun
JH
Kim
Shung Chull
SC
Chae
Young Jo
YJ
Kim
Seung Ho
SH
Hur
In Whan
IW
Seong
Taek Jong
TJ
Hong
Donghoon
D
Choi
Myeong Chan
MC
Cho
Chong Jin
CJ
Kim
Ki Bae
KB
Seung
Wook Sung
WS
Chung
Yang Soo
YS
Jang
Jeong Gwan
JG
Cho
Seung Jung
SJ
Park