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Relationship between blood pressure and cardiac events in patients with a healed myocardial infarction
M Wufuer1, K Ishikawa, T Takenaka
1First Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan.
Insights
Diastolic blood pressure (DBP) did not significantly impact cardiac events in patients with healed myocardial infarction. Cardiac events showed a J-shaped trend with DBP but lacked statistical significance, suggesting DBP is not a key predictor in this population.
Area of Science:
- Cardiology
- Hypertension Research
- Clinical Outcomes
Background:
- Patients with healed myocardial infarction (MI) face risks of recurrent cardiac events.
- Blood pressure, specifically diastolic blood pressure (DBP), is a critical factor in cardiovascular health.
- Understanding the relationship between DBP and cardiac events post-MI is essential for risk stratification and management.
Purpose of the Study:
- To investigate the association between diastolic blood pressure (DBP) and cardiac events in patients with a history of myocardial infarction (MI).
- To compare the incidence of cardiac events across different DBP categories: low (<70 mmHg), middle (70-89 mmHg), and high (>=90 mmHg).
- To determine if DBP influences the occurrence of recurrent MI, congestive heart failure death, or sudden death post-MI.
Main Methods:
- A cohort study of 6,602 patients with healed MI was conducted from January 1986 to January 1999.
- Patients were categorized into three DBP groups: low, middle, and high.
- Cardiac events, defined as recurrent MI, death from congestive heart failure, or sudden death, were the primary endpoints.
Main Results:
- No statistically significant difference in cardiac death or total mortality was observed among the three DBP groups.
- Cardiac events occurred in 3.3% of the low DBP group, 2.5% of the middle DBP group, and 3.7% of the high DBP group.
- A J-shaped trend between DBP and cardiac events was noted, but it did not reach statistical significance. Higher prevalence of cardiac events was observed with systolic blood pressure (SBP) <120 mmHg.
Conclusions:
- Diastolic blood pressure (DBP) does not appear to significantly influence the occurrence of cardiac events in patients with healed myocardial infarction.
- While a J-shaped correlation was observed, the lack of statistical significance suggests DBP is not a primary predictor of cardiac events in this cohort.
- Further research may be warranted to explore the role of systolic blood pressure (SBP) and other factors in cardiac event risk post-MI.
Abstract:
This study investigated the association between blood pressure (diastolic [DBP] and systolic [SBP]) and cardiac events in a total of 6,602 patients with a healed myocardial infarction (MI) (5,320 men, 1,282 women; mean age, 58.9+/-10.4 years), including in-patients and out-patients, from January 1986 to January 1999. The primary endpoints (cardiac events) were recurrent MI (fatal and non-fatal), death from congestive heart failure, or sudden death. The total number of cardiac events was 195 (3.0%) and the incidences of the 3 cardiac events were compared among the 3 DBP groups (DBP low group, <70 mmHg; DBP middle group, 70-89 mmHg; DBP high group, > or =90 mmHg). There were some significant differences in the characteristics of patients among the 3 groups, but no significant difference in cardiac death and total mortality was found among the 3 groups. Cardiac events occurred in 59 of 1,780 patients (3.3%, 33.9/1,000 person years) in the DBP low group, tended to be reduced in number in the DBP middle group (87 of 3,549 patients 2.5%, 21.4/1,000 person years) and were slightly increased in number in the DBP high group (24 of 642 patients 3.7%, 35.2/1,000 person years). Although this correlation between BP and cardiac events appears to be J-shaped, because there is no statistically significant difference in the rate of cardiac events among the 3 groups, we conclude that DBP does not influence the occurrence of cardiac events. The prevalence of cardiac events tended to be greater with a SBP less than 120 mmHg.
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