Blood pressure and other risk factors before the onset of myocardial infarction in hypertensive patients.

Abstract

To investigate blood pressure (BP) as well as other risk factors before the onset of myocardial infarction in hypertensive patients, we analysed the BP and metabolic variables in 94 hypertensive patients who had been followed up in our out-patient clinic before the first onset (M1 group; n = 42, 69 +/- 1 years, mean +/- s.e.) or the recurrent onset (M2 group; n = 52, 69 +/- 1 years) of myocardial infarction. Ninety-four hypertensive outpatients who had no history of serious cardiovascular diseases (C group) were also recruited for an age- and sex-matched case-control study. The majority of the patients were taking anti-hypertensive drugs (M1: 90%; M2: 98%; C: 90%). The average BP values for 1 year before the onset of myocardial infarction were used for the analysis. The BPs before the onset of myocardial infarction were 147 +/- 2 mm Hg systole and 81 +/- 2 mm Hg diastole in the M1 group, and 141 +/- 2 mm Hg systole and 78 +/- 1 mm Hg diastole in the M2 group, while those of the C group were 146 +/- 1 mm Hg systole and 84 +/- 1 mm Hg diastole. The diastolic BP of the M2 group was significantly lower than that of the C group (P < 0.0001). In patients aged > or =69 years, the diastolic BP of the M1 and M2 groups (M1: 77 +/- 1 mm Hg; M2: 75 +/- 1 mm Hg) were significantly lower than that of the C group (83 +/- 1 mm Hg). The fasting blood glucose of the M1 and M2 groups was higher than that of the C group. The serum HDL cholesterol of the M1 group was lower than that of the other groups. These results suggest that, in addition to glucose and lipid metabolism disorders, low diastolic BP is associated with the onset of myocardial infarction, especially in reinfarction and in elderly hypertensive patients.