Prognosis in hypertensives with acute myocardial infarction

Herlitz, Johan; Karlson, BW; Richter, Arina; Wiklund, Olov; Jablonskiene, D; Hjalmarson, Å.

doi:10.1097/00004872-199210000-00022

Cited by 35 publications

(24 citation statements)

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“…[2][3][4][5] Of relevance to the AIRE study population is the observation that a history of hypertension increases the mortality risk at all levels of left ventricular ejection fraction and pulmonary congestion after AMI. 6 However, these associations were established by studies that had been conducted before the routine use of ACE inhibitors.…”

Section: Prognostic Value Of Antecedent Hypertension After Amimentioning

confidence: 99%

“…Several studies performed in the previous decade demonstrated that a history of antecedent hypertension is a negative independent prognostic factor after AMI. [2][3][4][5] In addition, the deleterious effect of a history of hypertension in post-AMI patients is highlighted by the fact that it increases the mortality risk at all levels of left ventricular (LV) ejection fraction and pulmonary con-gestion. 6 However, it is unknown whether antecedent hypertension retains its negative prognostic influence in contemporary post-AMI patients routinely treated with angiotensin-converting enzyme (ACE) inhibitor therapy.…”

Section: Introductionmentioning

confidence: 99%

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The prognostic significance of a history of systemic hypertension in patients randomised to either placebo or ramipril following acute myocardial infarction: evidence from the AIRE study

1999

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Background: After acute myocardial infarction (AMI), patients with a history of arterial hypertension (AH) have a worse prognosis than normotensives. Whether this adverse risk is beneficially modulated by treatment with angiotensin-converting enzyme (ACE) inhibitors is unknown. We evaluated the prognostic value of antecedent hypertension in post-AMI patients given ACE inhibitor therapy. Methods: We analysed retrospectively data from the AIRE study (randomised, placebo-controlled trial of ramipril in 2006 post-AMI patients with clinical heart failure). A history of AH was present in 28% of the patients. We examined the prognostic value of antecedent hypertension separately among placebo and ramipril treated patients and also the effect of ramipril on clinical outcomes according to whether or not a history of AH was present.

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Section: Prognostic Value Of Antecedent Hypertension After Amimentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The prognostic significance of a history of systemic hypertension in patients randomised to either placebo or ramipril following acute myocardial infarction: evidence from the AIRE study

1999

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“…It has been shown that after thrombolysis for acute myocardial infarction (AMI), antecedent hypertension increases the risk of heart failure (HF) and other adverse events. [1][2][3][4][5] The progression to HF after AMI is mainly related to left ventricular (LV) remodeling. 6 However, animal 7,8 and human studies 5,9,10 evaluating the relation between hypertension and early LV remodeling after AMI have yielded conflicting or inconclusive results.…”

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confidence: 99%

Heart Failure and Left Ventricular Remodeling After Reperfused Acute Myocardial Infarction in Patients With Hypertension

et al. 2006

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Abstract-In the thrombolytic era, hypertension has been shown to adversely affect the development of heart failure after acute myocardial infarction (AMI). We sought to examine the relation between antecedent hypertension and heart failure after mechanical reperfusion and to test the impact of postinfarction left ventricular remodeling on heart failure in hypertensive patients. A series of 953 patients (324 hypertensives) with AMI treated with successful primary percutaneous coronary intervention underwent a 5-year follow-up. A subgroup of 325 subjects underwent 2D echocardiography at admission, 1 month, and 6 months. From day 1 to 6 months, despite similar improvement in regional and global left ventricular function and similar 6-month infarct artery patency rate, left ventricular end-diastolic volume increased in the normotensives (122Ϯ36 mL to 131Ϯ47 mL; PϽ0.001) but not in the hypertensives (127Ϯ41 mL to 128Ϯ31 mL; Pϭ0.768). At 6 months, the incidence of left ventricular remodeling in hypertensive and normotensive patients was not different (22% versus 28%; Pϭ0.210). However, at 5 years, the incidences of hospitalization for heart failure (7% versus 3%; Pϭ0.014) and of New York Heart Association functional class Ն2 (53% versus 40%; PϽ0.001) were higher in hypertensive as compared with normotensive patients. Hypertension was found to be a predictor of heart failure (hazard ratio, 2.23; Pϭ0.015). In conclusion, patients with antecedent hypertension are at higher risk to develop heart failure after AMI, even when successfully reperfused by primary percutaneous coronary intervention. However, the increased incidence of heart failure in hypertensive patients is not associated with a greater propensity to postinfarction left ventricular remodeling. Key Words: heart failure Ⅲ hypertrophy Ⅲ remodeling Ⅲ coronary artery disease Ⅲ myocardial infarction H ypertension is a well-known risk factor for coronary artery disease and heart failure. It has been shown that after thrombolysis for acute myocardial infarction (AMI), antecedent hypertension increases the risk of heart failure (HF) and other adverse events. [1][2][3][4][5] The progression to HF after AMI is mainly related to left ventricular (LV) remodeling. 6 However, animal 7,8 and human studies 5,9,10 evaluating the relation between hypertension and early LV remodeling after AMI have yielded conflicting or inconclusive results.Several studies have demonstrated that mechanical reperfusion (primary percutaneous coronary intervention, PCI) is superior to pharmacological reperfusion (thrombolysis), because it allows brisk and sustained flow achievement in the infarct-related artery (IRA) in a higher proportion of patients with subsequent improved myocardial salvage and better long-term outcome. 11 Thus, in the last decade, an increasing number of centers have adopted primary PCI as the preferred reperfusion therapy for AMI.In this study, we sought to examine the relation between antecedent hypertension and the development of HF after successful primary PCI for AMI. An...

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“…3 BP measurements made in the clinic or office; Thus, at least in theory, the potentially remediable (2) there is a higher incidence of cardiovascular character of hypertension is important when efforts complications when night time BP remains high; to reduce post-MI morbidity and mortality are con-(3) BP variability itself is an independent determisidered. Whilst in general, hypotension is more nant of target organ damage; common than hypertension in post-MI patients with (4) the incidence of cardiovascular events peaks in impaired systolic left ventricular (LV) function.…”

Section: Introduction Mia And/or Hypertension Accurate Identificatiomentioning

confidence: 99%

Importance of trough : peak ratios in treatment of blood pressure in post-myocardial infarction and heart failure settings

Modesti

1997

J Hum Hypertens

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Hypertension increases the risk of reinfarction and sudpotentially be met by use of ACE inhibitors. However, achieving quality BP control demands appropriate den death in the post-myocardial infarction patient, and the same also applies to the co-existing left ventricular selection of doses and dosage regimens. Trough : peak ratios are useful in determining duration of action and hypertrophy (LVH). Thus the therapeutic aim in such patients are: (1) appropriate blood pressure (BP) conmay thus offer a rational approach to aid the selection drug doses and dosage regimens. trol; (2) regression of LVH; and (3) secondary prevention to reduce long-term mortality. All of these goals can Keywords: trough:peak ratio; antihypertensive response; post MI; heart failure; 24-h blood pressure control may be a manifestation of severe myocardial ischae-

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Prognosis in hypertensives with acute myocardial infarction

Cited by 35 publications

References 0 publications

The prognostic significance of a history of systemic hypertension in patients randomised to either placebo or ramipril following acute myocardial infarction: evidence from the AIRE study

The prognostic significance of a history of systemic hypertension in patients randomised to either placebo or ramipril following acute myocardial infarction: evidence from the AIRE study

Heart Failure and Left Ventricular Remodeling After Reperfused Acute Myocardial Infarction in Patients With Hypertension

Importance of trough : peak ratios in treatment of blood pressure in post-myocardial infarction and heart failure settings

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