title: Admission blood pressure and 1-year mortality in acute myocardial infarction.
abstract: OBJECTIVE
  Arterial hypertension is a well-established factor for increased risk of cardiovascular diseases, but low admission blood pressure has also been suggested as predictor for increased mortality. We hypothesised that in patients with acute myocardial infarction admission blood pressure at the Emergency Department predicts long-term mortality.
  
  
  METHODS
  We included consecutive patients treated for acute myocardial infarction (AMI) at our 2,200-bed tertiary care hospital from 1991 to 2009 into our cohort. Systolic, diastolic and pulse pressure on admission were analysed as main predictors for 1-year mortality. We adjusted for several baseline factors and tested for interactions using multivariable regression models.
  
  
  RESULTS
  We included 3943 patients among whom 3604 were alive after 1 year. With increasing admission blood pressure 1-year mortality risk decreased incrementally to a 70% reduced relative risk in the highest blood pressure categories vs. the lowest categories. This effect was independent of blood pressure modifying interventions.
  
  
  CONCLUSIONS
  In acute myocardial infarction, admission blood pressure predicts long-term mortality in an inverse relation. With increasing admission blood pressure long-term mortality decreases. Low admission blood pressure should serve as a warning sign in patients with AMI. Admission blood pressure should therefore be interpreted in opposite to the regular, preventive, point of view.
authors: Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
authors: D
authors: D
authors: Roth
authors: Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
authors: R
authors: R
authors: Van Tulder
authors: Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
authors: B
authors: B
authors: Heidinger
authors: Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
authors: H
authors: H
authors: Herkner
authors: Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
authors: W
authors: W
authors: Schreiber
authors: Department of Emergency Medicine, Medical University of Vienna, Vienna, Austria.
authors: C
authors: C
authors: Havel
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000503:physiopathology; D012307:Risk Factors; D013997:Time Factors