PP.01.27

Abstract

Objective: In order to explain the relation between hypertension (HT) and acute ST elevation myocardial infarction (STEMI), the following considerations should be made: risk factors are shared by both diseases and hypertension is associated with the development of atherosclerosis. The aim of the present paper is to focus on hypertensive patients with acute STEMI, in order to better elucidate whether these patients are at higher risk than non-hypertensive patients. Design and method: A retrospective study was performed on a total of 76 patients presenting with STEMI in the period July 2014 – December 2014 in the Cardiology Department of the Emergency Hospital of Bucharest. Out of the 76 patients, 49 (64.5%) were found to be hypertensive. The study was further conducted on the 49 hypertensive patients. Their blood pressure (BP) was closely monitored in the intensive coronary care unit and diagnosis of HT was based on multiple measurements: at least 3/day, for at least 3 consecutive days. Results: The prevalence of hypertensive patients with STEMI was higher in males (71.4%) than females (28.6%). 81.6% of these patients had a BMI >25 and 55.1% were smokers. During their hospitalization, 6.1% of the cases required resuscitation due to ventricular tachycardia (VT)/ ventricular fibrillation (VF), compared to 3.7% in the non-hypertensive group. Left ventricular hypertrophy (LVH) was documented by echocardiography in 36.7% in the hypertensive group and 22.2% in the non-hypertensive group. Left ventricular dysfunction at discharge was 85.7% in the hypertensive group and 81.4% in the non-hypertensive group. The management of the acute MI was PCI in 65.3% and thrombolytics in 34.7% of cases. The main cause of coronary artery obstruction was due to atherosclerosis which was present in 95.9% while embolism and thrombosis counted for 2% each. The most common treatment used for HT was the combination of a beta-blocker and an ACE inhibitor which counted for 34.7%. Conclusions: HT is associated with an increased rate of adverse events after MI. In follow-up, efforts should target efficient long-term control of BP values, as a measure to decrease the possibility of future acute coronary syndromes.