Incidence Of First Myocardial Infarction Research Articles

Sex-specific trends in incidence of first myocardial infarction among people with and without diabetes between 1985 and 2016 in a German region

BackgroundThe reduction of myocardial infarction (MI) and narrowing the gap between the populations with and without diabetes are important goals of diabetes care. We analyzed time trends for sex-specific incidence rates (IR) of first MI (both non-fatal MI and fatal MI) as well as separately for first non-fatal MI and fatal MI in the population with and without diabetes.MethodsUsing data from the KORA myocardial infarction registry (Augsburg, Germany), we estimated age-adjusted IR in people with and without diabetes, corresponding relative risks (RR), and time trends from 1985 to 2016 using Poisson regression.ResultsThere were 19,683 people with first MI (34% fatal MI, 71% men, 30% with diabetes) between 1985 and 2016. In the entire study population, the IR of first MI decreased from 359 (95% CI: 345–374) to 236 (226–245) per 100,000 person years. In men with diabetes, IR decreased only in 2013–2016. This was due to first non-fatal MI, where IR in men with diabetes increased until 2009–2012, and slightly decreased in 2013–2016. Overall, fatal MI declined stronger than first non-fatal MI corresponding to IRs. The RR of first MI substantially increased among men from 1.40 (1.22–1.61) in 1985–1988 to 2.60 (2.26–2.99) in 1997–2000 and moderately decreased in 2013–2016: RR: 1.75 (1.47–2.09). Among women no consistent time trend for RR was observed. Time trends for RR were similar regarding first non-fatal MI and fatal MI.ConclusionsOver the study period, we found a decreased incidence of first MI and fatal MI in the entire study population. The initial increase of first non-fatal MI in men with diabetes needs further research. The gap between populations with and without diabetes remained.

Abstract 17023: Early Incidence of First Myocardial Infarction in Adult Attention Deficit Hyperactivity Disorder Patients in the United States

Background: Behavioral patterns and pharmaceutical interventions in patients with attention deficit hyperactivity disorder(ADHD) might increase the risk of cardiovascular disease. Studies evaluating the differences in risk profiles and outcomes during first myocardial infarction in ADHD patients compared to the general population in the US are lacking. Methods: We performed a retrospective cohort analysis of the US National Inpatient Sample years 2005 - 2015 using appropriate ICD-9 codes to identify a weighted sample of hospitalizations for a first acute myocardial infarction (AMI) in adults. In this AMI cohort, patients with ADHD were identified. Differences in demographics, comorbidities, and outcomes were compared between patients with and without ADHD. Results: Of 4,285,185 first AMI cases, ADHD was present in 5379 (~1 in 1000). At the time of first AMI, patients with ADHD were 15 years younger (mean age 52 vs 67 years, p<.001) and were more likely to be men (72% vs 58%, p<.001) than those without. More patients with ADHD had private insurance and were in higher income categories; TABLE. Patients with ADHD had higher prevalence of substance abuse, smoking, obesity, dyslipidemia and depression whereas patients without ADHD had a higher prevalence of hypertension and diabetes mellitus. While the type of AMI was similar in both the groups, mechanical revascularization was more frequently performed in ADHD patients (69.4% vs 59.1%, p<.001). All-cause inhospital mortality during the first AMI was significantly lower in ADHD patients (1.3% vs 6.1%, p<.001). Conclusion: In the US, patients with ADHD had first AMI at a much younger age and had substantial differences in risk factor profile and outcomes compared to the general population. The influence of behavior patterns, underlying ADHD pathophysiology, and medical interventions in ADHD patients leading to the earlier AMI onset should be further explored.

Constituent country inequalities in myocardial infarction incidence and case fatality in men and women in the United Kingdom, 1996-2005

Understanding myocardial infarction (MI) incidence and case fatality trends across the four UK constituent countries is of importance following devolution of the government of health-care services. Retrospective cohort study using a primary care database (5.19 million patients) examining trends in incidence of first MI and 30-day case fatality. From 1996 to 2005, the incidence of MI decreased in all countries, but reductions were greater in England (men, -3.1%; women, -2.8%) and Wales (men, -3.3%; women, -4.6%) than in Scotland (men, -1.9%; women, -0.6%) and Northern Ireland (men no change, women, -0.8%) (average annual percentage change). Greater reductions in England and Wales than Scotland and Northern Ireland meant a widening of north-south difference in MI incidence over the study period. Downward trends in 30-day case fatality were found in each country but less regional variation was evident (England men, -12.0%, women, -11.0%; Wales men, -18.4%, women, -12.6%; Scotland men, -9.5%, women, -9.0%; Northern Ireland men, -8.6%, women, -13.0%). From 1996 to 2005, downward trends in the incidence of first MI and 30-day case fatality were evident in each constituent country. Greater improvements in case fatality, compared with incidence, were found within each country.

Renal function assessed by two different formulas and incidence of myocardial infarction and death in middle‐aged men and women

Chronic kidney disease predicts mortality in the general population, but less is known about the association with incidence of first myocardial infarction. We evaluated glomerular filtration rates (GFR) estimated by the Modification of Diet in Renal Disease study (GFR-MDRD) equation and the Mayo formula (GFR-Mayo) as predictors of myocardial infarction and death. In 571 353 Swedish men and women, undergoing health controls, with mean age 45 years, and no previous myocardial infarction, hazard ratios were calculated to assess the association between renal function and incidence of myocardial infarction and all-cause mortality, respectively. Glomerular filtration rate 60-90, 30-60 and <30 mL per minute per 1.73 m(2), was defined as mildly, moderately and severely decreased GFR, respectively. There were 19 510 myocardial infarctions and 56 367 deaths during 11.6 years of follow-up. Hazard ratios (and 95% confidence intervals) for myocardial infarction, using GFR-Mayo were 1.11 (1.06-1.16) for mildly, 1.32 (1.18-1.48) for moderately and 2.54 (1.90-3.40) for severely decreased GFR. The corresponding figures for GFR-MDRD were 1.01 (0.96-1.05), 1.23 (1.14-1.32) and 2.49 (1.85-3.35). Mortality was increased at all levels of reduced GFR-Mayo and at moderately or severely decreased GFR-MDRD. Already mildly decreased GFR increase the risk of myocardial infarction and death in the general population. The association with adverse outcomes is stronger when GFR-Mayo rather than GFR-MDRD is used to assess renal function.

Acute myocardial infarction incidence in immigrants to Sweden. Country of birth, time since immigration, and time trends over 20 years

This study investigates incidence of first acute myocardial infarction (MI) among foreign born persons in Sweden using case control methods, taking into consideration country of birth, gender, socio-economic group and time since immigration and evaluates if the decreasing incidence of MI in Sweden during the study period was also present in immigrants. The study base consisted of persons 30-74 years of age in Stockholm County 1977-96. All incident cases of first acute MI in the study population were identified using registers of hospital discharges and deaths. Controls were selected randomly from the study base and the sampling fractions were known, enabling estimates of person time at risk. Foreign born subjects had a higher incidence of MI than subjects born in Sweden (men RR[Relative risk]=1,17; 95% CI 1,13-1,21; women RR = 1,15; 95% CI 1,09-1,21) after adjustment for calendar year, age and socio-economic group. An increased incidence was present primarily in subjects born in Finland, other Nordic countries, Poland, Turkey, Syria and South Asia in both genders, from the Netherlands among men and from Iraq among women and was still present after more than 20 years in Sweden. The incidence rate of MI 1977-96 among foreign born persons followed the general decline in the Swedish population. We conclude that foreign born persons in Sweden have an increased incidence of first MI which persists several years after immigration and is not explained by socio-economic differences. It is likely that this to an important extent has a background in factors in the country of origin.

Use of nicotine replacement therapy and the risk of acute myocardial infarction, stroke, and death

Objective: To determine whether nicotine replacement therapy (NRT) is associated with an increased risk of acute myocardial infarction, acute stroke, or death. Design: Self control case series analysis of data...

Myocardial infarction in diabetic and non-diabetic persons with and without prior myocardial infarction: the FINAMI Study

We compared the risk of acute coronary events in diabetic and non-diabetic persons with and without prior myocardial infarction (MI), stratified by age and sex. A Finnish MI-register study known as FINAMI recorded incident MIs and coronary deaths (n=6988) among people aged 45 to 74 years in four areas of Finland between 1993 and 2002. The population-based FINRISK surveys were used to estimate the numbers of persons with prior diabetes and prior MI in the population. Persons with diabetes but no prior MI and persons with prior MI but no diabetes had a markedly greater risk of a coronary event than persons without diabetes and without prior MI. The rate of recurrent MI among non-diabetic men with prior MI was higher than the incidence of first MI among diabetic men aged 45 to 54 years. The rate ratio was 2.14 (95% CI 1.40-3.27) among men aged 50. Among elderly men, diabetes conferred a higher risk than prior MI. Diabetic women had a similar risk of suffering a first MI as non-diabetic women with a prior MI had for suffering a recurrent MI. Both persons with diabetes but no prior MI, and persons with a prior MI but no diabetes are high-risk individuals. Among men, a prior MI conferred a higher risk of a coronary event than diabetes in the 45-54 year age group, but the situation was reversed in the elderly. Among diabetic women, the risk of suffering a first MI was similar to the risk that non-diabetic women with prior MI had of suffering a recurrent MI.

Aspirin and cardiovascular disease prevention in women: new findings from the Women’s Health Study

‘The bottom line is that women considering the use of aspirin to prevent CVD must weigh the balance of benefits and risks in consultation with their physicians before beginning therapy.’ Results from the first large-scale randomized trial of aspirin in the primary prevention of cardiovascular disease (CVD) in women are now available. Although aspirin had been shown to be effective in the treatment of acute myocardial infarction (MI) and in the secondary prevention of CVD among both women and men, there had been few data to inform current guidelines for the use of aspirin in primary prevention in women. Such guidelines have been based largely on results from trials in men, which suggest that aspirin reduces incidence of first MI by approximately a third while having little or no effect on stroke. The new findings suggest a nearly opposite pattern in women. The Women’s Health Study (WHS) was a randomized, double-blind, placebo-controlled trial to evaluate the benefits and risks of low-dose aspirin (100 mg on alternate days) and vitamin E in the primary prevention of CVD and cancer among women [1]. The trial included 39,876 initially healthy female health professionals aged 45 years and older who were followed for an average of 10 years. During follow-up, 477 major cardiovascular events (i.e., MI, stroke, and cardiovascular death) occurred among women assigned to the aspirin group, compared with 522 events among women in the placebo group, a 9% overall reduction that was not statistically significant (relative risk [RR], 0.91; 95% confidence interval [CI], 0.80–1.03; p = 0.13). However, in a pattern different from that found in trials in men, this 9% overall reduction was due almost entirely to statistically significant reductions in stroke events without a reduction in MI rates. Specifically, aspirin lowered the risk of total stroke by 17% (RR, 0.83; 95% CI, 0.69–0.99; p = 0.04) and the risk of ischemic stroke by 24% (RR, 0.76; 95% CI, 0.63–0.93, p = 0.009) but had no effect on the risk of MI (RR, 1.02: 95% CI, 0.84–1.25; p = 0.83) or cardiovascular death (RR, 0.95; 95% CI, 0.74–1.22; p = 0.68). This set of results is intriguing in light of the gender-specific pattern of CVD incidence in the US population – namely, that CVD events in women are more likely to be strokes than MIs, whereas the reverse in true in men. With respect to side effects, aspirin, as expected, increased the risk of bleeding. Gastrointestinal hemorrhages requiring transfusion were significantly more common in women assigned to aspirin than in those assigned to placebo (RR, 1.40; 95% CI, 1.07–1.83; p = 0.02), and there was also a nonsignificant increase in the risk of hemorrhagic stroke (RR, 1.24; 95% CI, 0.82–1.87; p = 0.31). The most consistent cardiovascular benefits of aspirin were found among women aged 65 years and older, a group that comprised only 10% of the study population yet suffered a third of all cardiovascular events. Among these women, aspirin use led to a statistically significant 26% reduction in risk of major cardiovascular events (RR, 0.74; 95% CI, 0.59–0.92, p = 0.008), with a benefit on both ischemic stroke (RR, 0.70; 95% CI, 0.49–1.00; p = 0.05) and MI (RR, 0.66; 95% CI, 0.44–0.97; p = 0.04). In contrast, for younger women, aspirin appeared to provide little or no cardiovascular protection.

Time trends in the incidence of myocardial infarction among professional drivers in Stockholm 1977–96

Aims: To investigate time trends in the incidence of first myocardial infarction (MI) among bus, taxi, and lorry drivers in Stockholm. Methods: In this population based case-control study, all first...

Trends in fatal and non‐fatal coronary heart disease events in Finland during 1991–2001

Objective—To analyse the trends in fatal and non‐fatal coronary heart disease (CHD) events in Finland during an 11‐year period 1991–2001.Design—Data on hospitalizations due to CHD in the Hospital Discharge Register were linked to the National Causes of Death Register in order to produce a Cardiovascular Disease Register including data on 271 771 events in 234 244 individuals.Results—The annual average decline in the age‐standardized CHD mortality rate was 5.2% (95% CI, −5.6, −4.8%) among men and 6.1% (−6.6, −5.6%) among women. The incidence of first myocardial infarction declined annually on average by 5.5% (−5.9, −5.1%) from 1991 to 1997 and by 2.4% (−3.0, −1.7%) from 1998 to 2001 among men. The respective changes among women were −5.9% (−6.5, −5.2%) and −1.7% (−2.7, −0.6%). The number of hospitalizations due to unstable angina pectoris increased between 1991 and 1996 (p=0.0002) and remained stable for the rest of the study period.Conclusions—The Cardiovascular Disease Register is a powerful tool for epidemiological monitoring of cardiovascular diseases in Finland.

Hormone replacement therapy, prothrombotic mutations, and the risk of incident nonfatal myocardial infarction in postmenopausal women.

Estrogens are known to be prothrombotic, and findings from the Heart and Estrogen/progestin Replacement Study suggest that in women with clinically recognized heart disease, hormone replacement therapy (HRT) may be associated with early harm and late benefit in terms of coronary events. To assess whether, as hypothesized, prothrombotic mutations modify the association between HRT use and incidence of first myocardial infarction (MI). Population-based, case-control study conducted in a Seattle-based health maintenance organization. Cases were 232 postmenopausal women aged 30 to 79 years who had their first nonfatal MI between 1995 and 1998. Controls were a stratified random sample of 723 postmenopausal women without MI who were frequency-matched to cases by age, calendar year, and hypertension status. Risk of first nonfatal MI based on current use of HRT and the presence or absence of coagulation factor V Leiden and prothrombin 20210 G-->A variants among cases and controls, stratified by hypertension. One hundred eight MI cases and 387 controls had hypertension and 124 MI cases and 336 controls did not. Among hypertensive women, the prothrombin variant was a risk factor for MI (odds ratio [OR], 4.32; 95% confidence interval [CI], 1.52-12.1) and, in this stratum, there was also a significant interaction between use of HRT and presence of the prothrombin variant on risk of MI. Compared with nonusers of HRT with wild-type genotype, women who were current users and who had the prothrombin variant (n = 8) had a nearly 11-fold increase in risk of a nonfatal MI (OR, 10.9; 95% CI, 2.15-55.2). The interaction with the prothrombin variant was more pronounced in analyses assuming 100% compliance than in those assuming 80% compliance with HRT. The interaction was absent among nonhypertensive women and was less pronounced if hypertensive and nonhypertensive women were combined into 1 group. No interaction was found for factor V Leiden in either hypertensive or nonhypertensive women. Among hypertensive women, the estimates were affected only in trivial ways by adjustment, and the interaction with the prothrombin variant was specific to HRT. Our results suggest that among postmenopausal hypertensive women, the association between HRT use and MI risk differed between those with and without the prothrombin 20210 G-->A variant. If these findings are confirmed in other studies, screening for the prothrombin variant may permit a better assessment of the risks and benefits associated with HRT in postmenopausal women.

Clustering of cardiovascular risk factors in type 2 diabetes mellitus: prognostic significance and tracking.

Little attention has been paid to the prognostic significance and tracking effect of risk factor clusters characteristic of type 2 diabetes mellitus. We studied the clustering of eight cardiovascular risk factors (smoking, high body mass index, elevated systolic blood pressure, high serum, low density lipoprotein (LDL) cholesterol, high serum LDL triglycerides, low serum, high density lipoprotein (HDL) cholesterol, high fasting blood glucose and high plasma insulin concentration) and their effect on the prognosis and the tracking effect. This study is a population-based prospective follow-up of newly diagnosed type 2 diabetic subjects (n = 133, aged 45-64 years) in Eastern Finland. The following end points were used: all-cause mortality, cardiovascular mortality, and incidences of first myocardial infarction and first stroke. Furthermore, we studied the 'tracking effect' of the risk factor clusters during the 10-year follow-up period. When the clustering of risk factors typical of type 2 diabetes mellitus was taken into account, all-cause mortality increased from 28.6% to 50.0% (p < 0.05) and cardiovascular disease mortality increased from 14.3% to 50.0% (p < 0.01) depending on the number of risk factors present. The incidence of first myocardial infarction increased from 0% to 40.0% (p < 0.05) as the number of risk factors increased from 0 to 5. In survivors, the proportion of individuals with no risk factors decreased and the proportion on individuals with three to four risk factors increased during the 10-year follow-up period despite the high mortality among the group with many risk factors. The risk factor clusters among type 2 diabetic subjects are of great predictive value and when not aggressively treated, show a relentless increase despite selective mortality.

Incidence of atherosclerotic arterial occlusive accidents in predialysis and dialysis patients: a multicentric study in the Ile de France district.

An abnormally high mortality from atherosclerotic cardiovascular (CV) accidents has long been reported in patients on maintenance haemodialysis (HD). However, incidence of atherosclerotic CV accidents had not been so far assessed in predialysis patients. In order to evaluate the respective influence of uraemia and the dialysis procedure, we compared incidence of atherosclerotic accidents before and after initiation of HD in a large population of patients. A total of 748 patients (411 male) were included in a retrospective study based on anamnestic data of patients living on maintenance haemodialysis in March 1993 in nine dialysis units of the Paris area. Incidence of first myocardial infarction (MI) or cerebral infarction (CI) was calculated by reference to the number of years of exposure to the risk both before and after initiation of HD in the various age groups. Overall, 103 first atherosclerotic accidents were recorded, including 10 CI (7 in males) and 93 MI (68 in males). Of the latter, 39 occurred before and 54 after start of HD, at a mean (+/-SD) age of 62.4+/-9.9 and 63.7+/-11.1 years respectively. The annual incidence of MI in males was 8.0, 19.5 and 28.3/1000 patient-years, before and 18.8, 21.6 and 29.9 patient-years after start of HD in the age groups 45-54.9, 55-64.9 and > or = 65 years respectively, compared to figures of 3.4, 7.5 and 10.4/1000 subject-years in the corresponding age groups in the general French population. Incidence of atherosclerotic CV accidents is nearly three times higher in uraemic patients than in the general population in the same age range in both genders. The fact that incidence and age at onset of first MI was similar in predialysis and in dialysed patients suggests that the uraemic state per se is a main determinant of such accelerated atherosclerosis.

The predictability of risk factors with respect to incidence and mortality of myocardial infarction and total mortality. A 12-year follow-up of the Oslo Study, Norway.

To study the prognostic value of several risk factors on incidence and mortality of myocardial infarction (MI) and total mortality in men. Prospective cohort study of 12 years' follow-up. All men in Oslo aged 40-49 and a 7% sample of men aged 20-39 were invited for screening. Of all 30,025 invited men, of whom 25,015 were aged 40-49, a total of 16,209 men aged 40-49 attended the screening and risk factors were recorded for these men. Incidence of first MI (non-fatal and fatal), mortality of MI, total mortality. When examining the rate ratio of the fifth to the first quintile of risk factors we found that systolic and diastolic blood pressures were stronger predictors for mortality than incidence of MI. The rate ratios (95% confidence interval) of systolic blood pressure were 3.73 (2.56, 5.44) and 2.56 (2.01, 3.25) respectively. For diastolic blood pressure the corresponding rate ratios were 4.14 (2.84, 6.04) and 2.78 (2.18, 3.54). Small differences in the rate ratios for these end-points were found for total serum cholesterol and triglycerides. Daily cigarette smoking versus non-cigarette smoking was a stronger predictor for MI mortality than incidence, with rate ratios of 3.16 (2.45, 4.24) and 2.34 (2.00, 2.79) respectively. The Cox proportional hazards regression analysis confirmed the above results. Total serum cholesterol and triglycerides predicted incidence and mortality of MI equally well. Whereas blood pressure and daily cigarette smoking predicted mortality of MI more strongly.

Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with stable chronic angina pectoris

Clinical trials have demonstrated a prophylactic role for aspirin in myocardial infarction and in unstable angina pectoris. The Swedish Angina Pectoris Aspirin Trial (SAPAT) is the first prospective study of aspirin in stable angina. 2035 patients were randomised double-blind to treatment with aspirin 75 mg daily or placebo. All patients were treated with sotalol for control of symptoms. The median duration of follow-up was 50 months. Compared with the placebo + sotalol group, the aspirin + sotalol group had a 34% (81 vs 124 patients) reduction in primary outcome events (myocardial infarction and sudden death; 95% confidence interval 24-49%; p=0·003) and the reduction observed in secondary outcome events (vascular events, vascular death, all cause mortality, stroke) ranged from 22% to 32%. Treatment withdrawal caused by adverse events occurred in 109 patients in the aspirin + sotalol group and 100 in patients in the placebo + sotalol group; major bleeds, including haemorrhagic stroke, occurred in 20 and 13 patients, respectively (not significant). The addition of a low dose of aspirin to sotalol treatment showed significant benefit in terms of cardiovascular events, including a significant reduction in the incidence of first myocardial infarction in patients with symptoms of stable angina pectoris.

Prognosis of patients with acute pulmonary edema and normal ejection fraction after acute myocardial infarction.

To assess the prognostic importance of resting left ventricular function in survivors of acute myocardial infarction with pulmonary edema, we retrospectively identified 39 consecutive patients who presented with acute pulmonary edema and myocardial infarction. Sixteen patients had radionuclide ejection fractions 10 +/- 2 days postinfarction of greater than 0.45 (group A, mean 0.55 +/- 0.06), and 23 patients had ejection fractions less than or equal to 0.45 (group B, 0.32 +/- 0.06). There were no significant differences between the two groups for age or sex, but group A patients had a significantly greater incidence of first myocardial infarction predominantly inferior in location. The calculated stroke work index during the acute event was significantly greater in group A than in group B (33.4 +/- 2.4 vs 23.4 +/- 2.0) (p less than 0.05). During a follow-up of 9 +/- 3 months, mortality was not significantly different between the two groups: Four (25%) died in group A and seven (30%) died in group B. In addition, eight patients (50%) in group A were hospitalized for recurrent angina, new myocardial infarction or recurrent pulmonary edema, compared with 11 (48%) in group B (NS). Three deaths in group A were preceded by infarction of the anterior wall of the left ventricle, confirmed at autopsy, and two nonfatal infarctions were anterior by electrocardiography. Four patients in group A had coronary arteriography performed during the follow-up period because of unstable angina, and all had significant (greater than or equal to 70% stenosis) three-vessel disease and two had left main coronary artery disease. Therefore, the predischarge ejection fraction did not predict prognosis for this group of patients. Patients with acute pulmonary edema in the course of myocardial infarction form a high-risk group despite good resting left ventricular function at discharge. They have a significant incidence of recurrent myocardial infarction and death and, because they have good residual left ventricular function, are excellent candidates for surgical intervention.

Beta-Adrenoceptor blockade and the incidence of myocardial infarction during treatment of severe hypertension.

British Journal of Clinical PharmacologyVolume 13, Issue 1 p. 91-93 Free Access beta-Adrenoceptor blockade and the incidence of myocardial infarction during treatment of severe hypertension. IM Stewart, IM StewartSearch for more papers by this author IM Stewart, IM StewartSearch for more papers by this author First published: January 1982 https://doi.org/10.1111/j.1365-2125.1982.tb01343.xCitations: 15AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat References STEWART, I. McD. G. (1976). Compared incidence of first myocardial infarction in hypertensive patients under treatment containing propranolol or excluding beta receptor blockade. Clin. Sci. mol. Med., 51, 509– 5IIS. STEWART, I. McD. G. (1979). Relation of reduction in pressure to first myocardial infarction in patients receiving treatment for severe hypertension. Lancet, i, 861– 865. Citing Literature Volume13, Issue1January 1982Pages 91-93 ReferencesRelatedInformation

Compared incidence of first myocardial infarction in hypertensive patients under treatment containing propranolol or excluding beta-receptor blockade.

1. After some exclusions, 169 severe uncomplicated essential hypertensive patients presenting consecutively were divided into two groups according to their treatment. Of these, 121 had been given longterm treatment containing propranolol (PC group) and forty-eight had been treated with hypotensive agents excluding any beta-receptor-blocker group, the non-beta-receptor-blocker (NBB) group. 2. There were no significant differences in myocardial infarction risk factors between the two groups. 3. After a mean follow-up of 5-25 years, nine of the 121 subjects (7-5%) in the PC group had suffered first infarctions and fifteen of the forty-eight subjects (31%) in the NBB group, a significant difference (P less than 0-01). 4. It was concluded that the presence of propranolol had prevented more or caused fewer infarctions, perhaps a combination of both, than had the older hypotensive agents unsupported by beta-receptor blockade.