Effect of antecedent hypertension and follow-up blood pressure on outcomes after high-risk myocardial infarction

J.J. Thune; J. Signorovitch; E.J. Velazquez; J.J. McMurray; R.M. Califf; A.P. Maggioni; J.L. Rouleau; J. Howlett; S. Zelenkofske; M.A. Pfeffer; S.D. Solomon; Lars Valeur Køber

doi:10.1161/HYPERTENSIONAHA.107.093682

Effect of antecedent hypertension and follow-up blood pressure on outcomes after high-risk myocardial infarction

J.J. Thune, J. Signorovitch, E.J. Velazquez, J.J. McMurray, R.M. Califf, A.P. Maggioni, J.L. Rouleau, J. Howlett, S. Zelenkofske, M.A. Pfeffer, S.D. Solomon, Lars Valeur Køber

56 Citations (Scopus)

Abstract

The influence of blood pressure on outcomes after high-risk myocardial infarction is not well characterized. We studied the relationship between blood pressure and the risk of cardiovascular events in 14 703 patients with heart failure, left ventricular systolic dysfunction, or both after acute myocardial infarction in the Valsartan in Myocardial Infarction Trial. We assessed the relationship between antecedent hypertension and outcomes and the association between elevated (systolic: >140 mm Hg) or low blood pressure (systolic: <100 mm Hg) in 2 of 3 follow-up visits during the first 6 months and subsequent cardiovascular events over a median 24.7 months of follow-up. Antecedent hypertension independently increased the risk of heart failure (hazard ratio [HR]: 1.19; 95% CI: 1.08 to 1.32), stroke (HR: 1.27; 95% CI: 1.02 to 1.58), cardiovascular death (HR: 1.11; 95% CI: 1.01 to 1.22), and the composite of death, myocardial infarction, heart failure, stroke, or cardiac arrest (HR: 1.13; 95% CI: 1.06 to 1.21). While low blood pressure in the postmyocardial infarction period was associated with increased risk of adverse events, patients with elevated blood pressure (n=1226) were at significantly higher risk of stroke (adjusted HR: 1.64; 95% CI: 1.17 to 2.29) and combined cardiovascular events (adjusted HR: 1.14; 95% CI: 1.00 to 1.31). Six months after a high-risk myocardial infarction, elevated systolic blood pressure, a potentially modifiable risk factor, is associated with an increased risk of subsequent stroke and cardiovascular events. Whether aggressive antihypertensive treatment can reduce this risk remains unknown
Udgivelsesdato: 2008/1

Original language	English
Journal	Hypertension
Volume	51
Issue number	1
Pages (from-to)	48-54
Number of pages	6
ISSN	0194-911X
DOIs	https://doi.org/10.1161/HYPERTENSIONAHA.107.093682
Publication status	Published - 2007

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10.1161/HYPERTENSIONAHA.107.093682

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Thune, J. J., Signorovitch, J., Velazquez, E. J., McMurray, J. J., Califf, R. M., Maggioni, A. P., Rouleau, J. L., Howlett, J., Zelenkofske, S., Pfeffer, M. A., Solomon, S. D., & Køber, L. V. (2007). Effect of antecedent hypertension and follow-up blood pressure on outcomes after high-risk myocardial infarction. Hypertension, 51(1), 48-54. https://doi.org/10.1161/HYPERTENSIONAHA.107.093682

Thune, JJ, Signorovitch, J, Velazquez, EJ, McMurray, JJ, Califf, RM, Maggioni, AP, Rouleau, JL, Howlett, J, Zelenkofske, S, Pfeffer, MA, Solomon, SD & Køber, LV 2007, 'Effect of antecedent hypertension and follow-up blood pressure on outcomes after high-risk myocardial infarction', Hypertension, vol. 51, no. 1, pp. 48-54. https://doi.org/10.1161/HYPERTENSIONAHA.107.093682

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title = "Effect of antecedent hypertension and follow-up blood pressure on outcomes after high-risk myocardial infarction",

abstract = "The influence of blood pressure on outcomes after high-risk myocardial infarction is not well characterized. We studied the relationship between blood pressure and the risk of cardiovascular events in 14 703 patients with heart failure, left ventricular systolic dysfunction, or both after acute myocardial infarction in the Valsartan in Myocardial Infarction Trial. We assessed the relationship between antecedent hypertension and outcomes and the association between elevated (systolic: >140 mm Hg) or low blood pressure (systolic: <100 mm Hg) in 2 of 3 follow-up visits during the first 6 months and subsequent cardiovascular events over a median 24.7 months of follow-up. Antecedent hypertension independently increased the risk of heart failure (hazard ratio [HR]: 1.19; 95% CI: 1.08 to 1.32), stroke (HR: 1.27; 95% CI: 1.02 to 1.58), cardiovascular death (HR: 1.11; 95% CI: 1.01 to 1.22), and the composite of death, myocardial infarction, heart failure, stroke, or cardiac arrest (HR: 1.13; 95% CI: 1.06 to 1.21). While low blood pressure in the postmyocardial infarction period was associated with increased risk of adverse events, patients with elevated blood pressure (n=1226) were at significantly higher risk of stroke (adjusted HR: 1.64; 95% CI: 1.17 to 2.29) and combined cardiovascular events (adjusted HR: 1.14; 95% CI: 1.00 to 1.31). Six months after a high-risk myocardial infarction, elevated systolic blood pressure, a potentially modifiable risk factor, is associated with an increased risk of subsequent stroke and cardiovascular events. Whether aggressive antihypertensive treatment can reduce this risk remains unknown Udgivelsesdato: 2008/1",

author = "J.J. Thune and J. Signorovitch and E.J. Velazquez and J.J. McMurray and R.M. Califf and A.P. Maggioni and J.L. Rouleau and J. Howlett and S. Zelenkofske and M.A. Pfeffer and S.D. Solomon and K{\o}ber, {Lars Valeur}",

note = "Keywords: Aged; Antihypertensive Agents; Blood Pressure; Captopril; Cardiovascular Diseases; Female; Follow-Up Studies; Heart Failure; Humans; Hypertension; Male; Middle Aged; Myocardial Infarction; Prognosis; Risk Factors; Stroke; Tetrazoles; Valine; Ventricular Dysfunction, Left",

year = "2007",

doi = "10.1161/HYPERTENSIONAHA.107.093682",

language = "English",

volume = "51",

pages = "48--54",

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T1 - Effect of antecedent hypertension and follow-up blood pressure on outcomes after high-risk myocardial infarction

AU - Thune, J.J.

AU - Signorovitch, J.

AU - Velazquez, E.J.

AU - McMurray, J.J.

AU - Califf, R.M.

AU - Maggioni, A.P.

AU - Rouleau, J.L.

AU - Howlett, J.

AU - Zelenkofske, S.

AU - Pfeffer, M.A.

AU - Solomon, S.D.

AU - Køber, Lars Valeur

N1 - Keywords: Aged; Antihypertensive Agents; Blood Pressure; Captopril; Cardiovascular Diseases; Female; Follow-Up Studies; Heart Failure; Humans; Hypertension; Male; Middle Aged; Myocardial Infarction; Prognosis; Risk Factors; Stroke; Tetrazoles; Valine; Ventricular Dysfunction, Left

PY - 2007

Y1 - 2007

N2 - The influence of blood pressure on outcomes after high-risk myocardial infarction is not well characterized. We studied the relationship between blood pressure and the risk of cardiovascular events in 14 703 patients with heart failure, left ventricular systolic dysfunction, or both after acute myocardial infarction in the Valsartan in Myocardial Infarction Trial. We assessed the relationship between antecedent hypertension and outcomes and the association between elevated (systolic: >140 mm Hg) or low blood pressure (systolic: <100 mm Hg) in 2 of 3 follow-up visits during the first 6 months and subsequent cardiovascular events over a median 24.7 months of follow-up. Antecedent hypertension independently increased the risk of heart failure (hazard ratio [HR]: 1.19; 95% CI: 1.08 to 1.32), stroke (HR: 1.27; 95% CI: 1.02 to 1.58), cardiovascular death (HR: 1.11; 95% CI: 1.01 to 1.22), and the composite of death, myocardial infarction, heart failure, stroke, or cardiac arrest (HR: 1.13; 95% CI: 1.06 to 1.21). While low blood pressure in the postmyocardial infarction period was associated with increased risk of adverse events, patients with elevated blood pressure (n=1226) were at significantly higher risk of stroke (adjusted HR: 1.64; 95% CI: 1.17 to 2.29) and combined cardiovascular events (adjusted HR: 1.14; 95% CI: 1.00 to 1.31). Six months after a high-risk myocardial infarction, elevated systolic blood pressure, a potentially modifiable risk factor, is associated with an increased risk of subsequent stroke and cardiovascular events. Whether aggressive antihypertensive treatment can reduce this risk remains unknown Udgivelsesdato: 2008/1

AB - The influence of blood pressure on outcomes after high-risk myocardial infarction is not well characterized. We studied the relationship between blood pressure and the risk of cardiovascular events in 14 703 patients with heart failure, left ventricular systolic dysfunction, or both after acute myocardial infarction in the Valsartan in Myocardial Infarction Trial. We assessed the relationship between antecedent hypertension and outcomes and the association between elevated (systolic: >140 mm Hg) or low blood pressure (systolic: <100 mm Hg) in 2 of 3 follow-up visits during the first 6 months and subsequent cardiovascular events over a median 24.7 months of follow-up. Antecedent hypertension independently increased the risk of heart failure (hazard ratio [HR]: 1.19; 95% CI: 1.08 to 1.32), stroke (HR: 1.27; 95% CI: 1.02 to 1.58), cardiovascular death (HR: 1.11; 95% CI: 1.01 to 1.22), and the composite of death, myocardial infarction, heart failure, stroke, or cardiac arrest (HR: 1.13; 95% CI: 1.06 to 1.21). While low blood pressure in the postmyocardial infarction period was associated with increased risk of adverse events, patients with elevated blood pressure (n=1226) were at significantly higher risk of stroke (adjusted HR: 1.64; 95% CI: 1.17 to 2.29) and combined cardiovascular events (adjusted HR: 1.14; 95% CI: 1.00 to 1.31). Six months after a high-risk myocardial infarction, elevated systolic blood pressure, a potentially modifiable risk factor, is associated with an increased risk of subsequent stroke and cardiovascular events. Whether aggressive antihypertensive treatment can reduce this risk remains unknown Udgivelsesdato: 2008/1

U2 - 10.1161/HYPERTENSIONAHA.107.093682

DO - 10.1161/HYPERTENSIONAHA.107.093682

M3 - Journal article

C2 - 18025296

SN - 0194-911X

VL - 51

SP - 48

EP - 54

JO - Hypertension

JF - Hypertension

IS - 1

ER -