Skip to main content
SpringerLink
Log in

Impact of Hypertension History on Short and Long-Term Prognosis in Patients with Acute Myocardial Infarction Treated with Percutaneous Angioplasty: Comparison Between STEMI and NSTEMI

  • Original Article
  • Published:
High Blood Pressure & Cardiovascular Prevention Aims and scope Submit manuscript

Abstract

Previous studies analyzing the impact of hypertension (HTN) on myocardial infarction (MI) outcome reached conflicting results and scarce data are available in patients treated with percutaneous coronary intervention (PCI). In this study the prognostic impact of HTN history in ST-elevation MI (STEMI) and Non-STEMI (NSTEMI) patients treated with PCI was analyzed. We compared characteristics of 1,031 STEMI and 437 NSTEMI patients, in relation to the presence of HTN. Median follow-up duration was 40.2 months. HTN was significantly higher in NSTEMI vs. STEMI patients (p < 0.001). NSTEMI patients were older, with higher values of left ventricular ejection fraction (LVEF) and more frequently with previous myocardial revascularization than STEMI patients either among hypertensives and non-hypertensives. At univariate analysis HTN resulted associated with long-term mortality in STEMI but not in NSTEMI patients. At multivariate analysis HTN was not associated with either in-hospital and long-term mortality in both NSTEMI and STEMI group. In conclusion, in the PCI era HTN does not influence MI patients prognosis; other factors, such as age, admission LVEF, coronary disease extension, previous MI and creatinine levels are independently associated with MI patients outcome even though this should not discourage from a strict control of HTN after the acute event.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Dzau VJ. Atherosclerosis and hypertension: mechanisms and interrelationships. J Cardiovasc Pharmacol. 1990;15:S59–64.

    Article  CAS  PubMed  Google Scholar 

  2. Murabito JM, D’Agostino RB, Silbershatz H, Wilson PWF. Intermittent claudication: a risk profile from the Framingham Heart Study. Circulation. 1997;96:44–9.

    Article  CAS  PubMed  Google Scholar 

  3. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–13.

    Article  PubMed  Google Scholar 

  4. Levy D, Wilson PWF, Anderson KM, Castelli WP. Stratifying the patient at risk from coronary disease: new insights from the Framingham Heart Study. Am Heart J. 1990;119:712–7.

    Article  CAS  PubMed  Google Scholar 

  5. Adamczak M, Zeier M, Dikow R, Ritz E. Kidney and hypertension. Kidney Int Suppl. 2002;61:S62–7.

    Article  Google Scholar 

  6. Richards AM, Nicholls MG, Troughton RW, Lainchbury JG, Elliott J, Frampton C, Espiner EA, Crozier IG, Yandle TG, Turner J. Antecedent hypertension and heart failure after myocardial infarction. JACC. 2002;39:1182–8.

    Article  PubMed  Google Scholar 

  7. Dumaine R, Gibson CM, Murphy SA, Southard M, Ly HQ, McCabe CH, Giugliano RP, Cannon CP, Antman EM, Braunwald E. Association of a history of systemic hypertension with mortality, thrombotic, and bleeding complications following non-ST segment elevation acute coronary syndrome. J Clin Hypertens. 2006;8:315–22.

    Article  Google Scholar 

  8. Willich SN. M¨uller-Nordhorn J, Kulig M, Binting S, Gohlke H, Hahmann H Bestehorn K, Krobot K, Völler H. Cardiac risk factors, medication, and recurrent clinical events after acute coronary disease: a prospective cohort study. Eur Heart J. 2001;22:307–13.

    Article  CAS  PubMed  Google Scholar 

  9. Yusuf PS, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, Lisheng L. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:937–52.

    Article  PubMed  Google Scholar 

  10. The GUSTO Investigators. An international randomized trial comparing four thrombolytic strategies for acute myocardial infarction. N Engl J Med. 1993;329:673–82.

    Article  Google Scholar 

  11. Fresco C, Avanzini F, Bosi S, Franzosi MG, Maggioni AP, Santoro L, Bellanti G. Prognostic value of a history of hypertension in 11 483 patients with acute myocardial infarction treated with thrombolysis. GISSI-2 Investigators. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico. J Hypertens. 1996;14:743–50.

    Article  CAS  PubMed  Google Scholar 

  12. Hasdai D, Behar S, Wallentin L, Danchin N, Gitt AK, Boersma E, Fioretti PM, Simoons ML, Battler A. A prospective survey of the characteristics, treatments and outcomes of patients with acute coronary syndromes in Europe and the Mediterranean basin: the Euro Heart Survey of Acute Coronary Syndromes (Euro Heart Survey ACS). Eur Heart J. 2002;23:1190–201.

    Article  CAS  PubMed  Google Scholar 

  13. Majahalme SK, Smith DE, Cooper JV, Kline-Rogers E, Mehta RH, Eagle KA, Bisognano JD. Comparison of patients with acute coronary syndrome with and without systemic hypertension. Am J Cardiol. 2003;92:258–63.

    Article  PubMed  Google Scholar 

  14. Task Force Members: Van de Werf F, Bax J, Betriu A, Blomstrom-Lundqvist C, Crea F, Falk V, Filippatos G, Fox K, Huber K, Kastrati A, Rosengren A, Steg PG, Tubaro M, Verheugt F, Weidinger F. Management of acute myocardial infarction in patients presenting with persistent ST-segment elevation. The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology. Eur Heart J. 2008; 29:2909–45.

    Google Scholar 

  15. Authors/Task Force Members: Hamm CW, Bassand JP, Agewall S, Bax J, Boersma E, Bueno H, Caso P, Dudek D, Gielen S, Huber K, Ohman M, Petrie MC, Sonntag F, Sousa Uva M, Storey RF. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2001; 32:2999–3054.

    Google Scholar 

  16. Mancia G, de Backer G, Dominiczak A, Cifkova R, Fagard R, Germano G, Grassi G, Heagerty AM, Kjeldsen SE, Laurent S, Narkiewicz K, Ruilope L, Rynkiewicz A, Schmieder RE, Struijker Boudier HAJ. Guidelines for the management of arterial hypertension. The task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J. 2007;28:1462–536.

    PubMed  Google Scholar 

  17. Frazier CG, Shah SH, Armstrong PW, Bhapkar MV, McGuire DK, Sadowski Z, Kristinsson A, Aylward PE, Klein WW, Weaver WD, Newby LK, SYMPHONY and the Second SYMPHONY Investigators. Prevalence and management of hypertension in acute coronary syndrome patients varies by sex: observations from the Sibrafiban versus aspirin to Yield Maximum Protection from ischemic Heart events postacute cOroNary sYndromes (SYMPHONY) randomized clinical trials. Am Heart J. 2005;150:1260–7.

    Article  CAS  PubMed  Google Scholar 

  18. Lazzeri C, Valente S, Chiostri M, Attanà P, Picariello C, Gensini GF. Impact of hypertension on short- and long-term prognoses in patients with ST elevation myocardial infarction and without previously known diabetes. Heart Vessel. 2012;27(4):370–6 Epub 2011 Jul 7.

    Article  Google Scholar 

  19. Cecchi E, Giglioli C, Valente S, Lazzeri C, Gensini GF, Abbate R, Mannini L. Role of hemodynamic shear stress in cardiovascular disease. Atherosclerosis. 2011;214:249–56.

    Article  CAS  PubMed  Google Scholar 

  20. Foresto P, D’Arrigo M, Filippini F, Gallo R, Barberena L, Racca L, Valverde J, Rasia RJ. Hemorheological alterations in hypertensive patients. Medicina (B Aires). 2005;65:121–5.

    Google Scholar 

  21. Spencer CG, Gurney D, Felmeden DC, Blann AD, Beevers DG, Lip GY. Platelet and hemorheological markers in high risk hypertensive are improved by tighter blood pressure control and cardiovascular risk management. J Intern Med. 2004;255:59–67.

    Article  CAS  PubMed  Google Scholar 

  22. Lembo G, Morisco C, Lanni F, Barbato E, Vecchione C, Fratta L, Trimarco B. Systemic hypertension and coronary artery disease: the link. Am J Cardiol. 1998;82(3A):2H–7H.

    Article  CAS  PubMed  Google Scholar 

  23. Rabkin SW, Mathewson FAL, Tate RB. Prognosis after acute myocardial infarction: relation to blood pressure values before infarction in a prospective cardiovascular study. Am J Cardiol. 1977;40:604–10.

    Article  CAS  PubMed  Google Scholar 

  24. Lingman M, Herlitz J, Bergfeldt L, Karlsson T, Caidhal K, Hartford M. Acute coronary syndrome—the prognostic impact of hypertension, diabetes and its combination on long-term outcome. Int J Cardiol. 2009;137:29–36.

    Article  PubMed  Google Scholar 

  25. Rembek M, Goch A, Goch J. The clinical course of acute ST-elevation myocardial infarction in patients with hypertension. Kardiologia Polska. 2010;68:157–63.

    PubMed  Google Scholar 

  26. Abrignani MG, Dominguez LJ, Biondo G, Di Girolamo A, Novo G, Barbagallo M, Braschi A, Braschi G, Novo S. Inhospital complications of acute myocardial infarction in hypertensive subjects. Am J Hypertens. 2005;8:165–70.

    Article  Google Scholar 

  27. Chin D, Battistoni A, Tocci G, Passerini J, Parati G, Volpe M. Non-invasive diagnostic testing for coronary artery disease in the hypertensive patient: potential advantages of a risk estimation-based algorithm. Am J Hypertens. 2012;25:1226–35.

    PubMed  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Heart and Vessels, Azienda Ospedaliero-Universitaria Careggi, Viale Morgagni, 85, 50134, Florence, Italy

    Emanuele Cecchi, Maria Grazia D’Alfonso, Marco Chiostri, Elena Parigi, Daniele Landi, Serafina Valente, Salvatore Mario Romano, Gian Franco Gensini & Cristina Giglioli

Authors
  1. Emanuele Cecchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Maria Grazia D’Alfonso
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marco Chiostri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Elena Parigi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Daniele Landi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Serafina Valente
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Salvatore Mario Romano
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gian Franco Gensini
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Cristina Giglioli
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cristina Giglioli.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cecchi, E., D’Alfonso, M.G., Chiostri, M. et al. Impact of Hypertension History on Short and Long-Term Prognosis in Patients with Acute Myocardial Infarction Treated with Percutaneous Angioplasty: Comparison Between STEMI and NSTEMI. High Blood Press Cardiovasc Prev 21, 37–43 (2014). https://doi.org/10.1007/s40292-013-0032-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40292-013-0032-1

Keywords

Search

Navigation