G034: Intrahospital complications of acute myocardial infarction in hypertensive patients. A retrospective case-control study

Recent clinical trials described in AMI a poorer in-hospital prognosis of hypertensives (H) in comparison to normotensives (NT) due to more prevalent ischaemic, arrhythmic, and functional complications. However, H pts are more often of female sex and advanced age than NT ones, and the negative prognostic impact of these factors is well known. Aim of the present study was to evaluate the clinical patterns concomitant diseases and risk factors, and the in-hospital complications in H pts with AMI. From our database of 3924 patients consecutively admitted to our I.C.C.U., over the period 1987–1998, we selected 791 pts with history hypertension, 433 males and 358 females, mean age 69,1 ± 9,3 years. As control group we evaluated 791 NT pts coupled for sex and age. It was not found any significant difference between controls and H, as regards the site of AMI, but the last group had a significantly (p < 0,01) higher number of ST depression at the entry (65.2 vs 42.3%) and of non Q wave AMI (83.5 vs 37.8%), as well as of previous AMI (32.1 vs 23.5%), diabetes (7.8 vs 5.2%), renal failure (4.4 vs 1.2%), peripheral arterial disease (2.7 vs 1.1%), dyslipidemia (33.3 vs 21.8%), CVD (3.9 vs 1.6%) and chronic obstructive lung disease (8.6 vs 4.4%). As regards in-hospital complications, H pts showed a significantly higher prevalence of post-AMI angina (9.9 vs 7.6%, p < 0.05), silent myocardial ischemia (1.4 vs 0.6%, p < 0.01) and paroxysmal AF (7.1 vs 3.8%, p < 0.01) as well as a significantly lower prevalence of deaths (5.2 vs 13.7%, p