Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Impact of High-Normal Blood Pressure Measured in Emergency Room on Adverse Cardiac Events in Acute Myocardial Infarction

  • Yoon, Nam-Sik (The Heart Center of Chonnam National University Hospital) ;
  • Jeong, Myung-Ho (The Heart Center of Chonnam National University Hospital) ;
  • Ahn, Young-Keun (The Heart Center of Chonnam National University Hospital) ;
  • Kim, Jong-Hyun (The Cardiovascular Center, Hanseo Hospital) ;
  • Chae, Shung-Chull (Department of Internal Medicine, Kyungpook National University Hospital) ;
  • Kim, Young-Jo (Department of Internal Medicine, Yeungnam University Hospital) ;
  • Hur, Seung-Ho (Department of Internal Medicine, Keimyung University Dongsan Medical Center) ;
  • Seong, In-Whan (Department of Internal Medicine, Chungnam National University Hospital) ;
  • Hong, Taek-Jong (Department of Internal Medicine, Pusan National University Hospital) ;
  • Choi, Dong-Hoon (Department of Internal Medicine, Yonsei University Severans Hospital) ;
  • Cho, Myeong-Chan (Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Kim, Chong-Jin (Department of Internal Medicine, Kyunghee University College of Medicine) ;
  • Seung, Ki-Bae (Department of Internal Medicine, The Catholic University of Korea Hospital) ;
  • Chung, Wook-Sung (Department of Internal Medicine, The Catholic University of Korea Hospital) ;
  • Jang, Yang-Soo (Department of Internal Medicine, Yonsei University Severans Hospital) ;
  • Cho, Jeong-Gwan (The Heart Center of Chonnam National University Hospital) ;
  • Park, Seung-Jung (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Other Korea Acute Myocardial Infarction Registry Investigators, (Korea Acute Myocardial Infarction Registry Investigators)
  • Published : 2012.05.31
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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 ($61{\pm}12.3$ 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 ($60.9{\pm}12.4$ years). Group II had 81 patients ($61.6{\pm}12.5$ 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.

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References

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