The influence of hypertension on in-hospital outcome in patients with acute myocardial infarction

Aim To examine the differences in the frequency of risk factors, clinical presentations on admission and in-hospital outcome in hypertensive and normotensive patients treated for acute myocardial infarction (AMI). Methods In hypertensive and normotensive patients with AMI we retrospectively analyzed risk factors (age, gender, smoking habits, diabetes, blood lipids, history of angina pectoris, previous myocardial infarction, previous stroke and family history of atherothrombotic disease), admission Killip class, localization of AMI, and in-hospital outcome. For group comparisons we used Student's t-test and chi(2) test. Values of p < 0.05 were considered significant. Results Out of 396 consecutive patients with AMI, 147 (37.1%) patients were women and 249 (62.9%) were men. Comparing to men, women presented more frequently with hypertension (55.1% vs. 42.6% for men, respectively). Hypertensive patients had smoking habits (16.6% vs. 26.8%) and previous myocardial infarction (2.1% vs. 7.7%) less frequently than normotensive patients. Normotensive patients had history of angina pectoris less frequently (12.0% vs. 21.4%). We did not find any significant differences in presence of other risk factors or admission Killip class. Normotensive patients had inferior AMI more frequently (35.9% vs. 25.7%). In-hospital mortality was significantly higher in normotensive patients (24.9% vs. 15.0%), and this difference persists after stratified analysis according to gender (16.8% vs. 7.5% for men; 42.4% vs. 24.7% for women). Conclusion Hypertensive patients with AMI have better in-hospital outcome than normotensive patients. It is not sufficient to analyze risk factors, clinical presentations on admission of patients with AMI stratified by hypertension status to accurately predict the early outcome.