Prognosis During Five Years of Follow-up Among Patients Admitted to the Emergency Department with Acute Chest Pain in Relation to a History of Hypertension

Abstract

Aim: To describe the mortality, mode and place of death and risk indicators of death during 5 years of follow-up among patients admitted to the emergency department (ED) with acute chest pain or other symptoms raising a suspicion of acute myocardial infarction (AMI) in relation to a history of hypertension. Methods: All the patients admitted to the ED at Sahlgrenska University Hospital during a period of 21 months with acute chest pain or other symptoms raising a suspicion of AMI were followed up prospectively for 5 years. Results: Of 5,355 patients fulfilling the inclusion criteria, 22% had a history of hypertension. Hypertensive patients differed from non-hypertensive patients in that there were more females, they were older and had a higher prevalence of previous cardiovascular disease. Patients with a history of hypertension had a 5-year mortality rate of 37.4% as compared with 22.2% among non-hypertensive patients (p < 0.001). The difference in mortality appeared to be more marked among patients without a history of cardiovascular disease. A history of hypertension was an independent predictor of death. Risk indicators of death appeared to be relatively similar among patients with and without a history of hypertension. Of the patients who died, those with a history of hypertension were more frequently judged to have suffered a cardiac death and died more frequently in association with an AMI. Conclusion: Among patients admitted to the ED with acute chest pain and with a history of hypertension, 37% died during the following 5 years. A history of hypertension was an independent predictor of death.