Korean Circ J.  2012 May;42(5):304-310. 10.4070/kcj.2012.42.5.304.

Impact of High-Normal Blood Pressure Measured in Emergency Room on Adverse Cardiac Events in Acute Myocardial Infarction

• Yoon NS
• Jeong MH
• Ahn Y
• Kim JH
• Chae SC
• Kim YJ
• Hur SH
• Seong IW
• Hong TJ
• Choi D
• Cho MC
• Kim CJ
• Seung KB
• Chung WS
• Jang YS
• Cho JG
• Park SJ
• Other Korea Acute Myocardial Infarction Registry Investigators

• KMID: 2028758
• DOI: http://doi.org/10.4070/kcj.2012.42.5.304

Abstract

BACKGROUND AND OBJECTIVES
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.
SUBJECTS AND 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.
CONCLUSION
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.

Keyword

Blood pressure; Prognosis

MeSH Terms

Blood Pressure
Demography
Emergencies
Follow-Up Studies
Humans
Korea
Myocardial Infarction
Odds Ratio
Prehypertension
Prognosis

Figure

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  Fig. 1 Cumulative major adverse cardiac events (MACE) free survival in group I (solid black line, normal blood pressure) and group II (dotted black line, high-normal blood pressure) using Kaplan-Meier analysis.

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