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Blood pressure measures and electrocardiogram-defined myocardial infarction in an Iranian population: Tehran Lipid

Arash Ghanbarian1, Arash Rashidi, Mohammad Madjid

  • 1Endocrine and Metabolism Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran. Azizi@erc-iran.com

Journal of Clinical Hypertension (Greenwich, Conn.)
|February 12, 2004
PubMed

Insights

This study found that higher systolic blood pressure is a better predictor of pulse pressure in Iranian adults, regardless of hypertension or myocardial infarction (MI) status. ECG-defined MI prevalence was higher in hypertensive individuals.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Hypertension is a significant risk factor for coronary artery disease.
  • Electrocardiogram (ECG) is a diagnostic tool for coronary artery disease, including myocardial infarction (MI).
  • Pulse pressure's predictive role in coronary artery disease is increasingly recognized, potentially surpassing that of blood pressure alone.

Purpose of the Study:

  • To describe blood pressure values in Iranian adults with ECG-defined myocardial infarction (MI).
  • To investigate the relationship between blood pressure, pulse pressure, and ECG-defined MI in an Iranian adult population.
  • To compare the predictive value of systolic and diastolic blood pressure for pulse pressure in different hypertensive and MI status groups.

Main Methods:

  • Analysis of data from 2479 men and 3060 women (aged >=30) from the Tehran Lipid and Glucose study, excluding those on antihypertensive medication.
  • Mean of two separate blood pressure measurements used for each individual.
  • ECG findings coded using Minnesota criteria, categorizing subjects into probable/possible MI or no MI groups.

Main Results:

  • ECG-defined MI prevalence was 1.2% (1.8% in men, 0.8% in women), with hypertensive individuals showing a two-fold higher prevalence than normotensives.
  • Mean diastolic blood pressure was significantly lower in subjects with ECG-defined MI compared to those without MI (p<0.03), after adjusting for age, sex, and BMI.
  • Systolic blood pressure demonstrated a strong positive correlation with pulse pressure across all groups (hypertensive/normotensive, MI/no MI). Diastolic blood pressure showed a weak inverse correlation with pulse pressure in normotensive/non-MI groups, but no correlation in MI cases.

Conclusions:

  • Systolic blood pressure is a more effective predictor of pulse pressure than diastolic blood pressure in both normotensive and hypertensive Iranian adults, irrespective of ECG-defined MI status.
  • The prevalence of ECG-defined MI is notably higher in hypertensive individuals.
  • Findings highlight the importance of systolic blood pressure and pulse pressure in cardiovascular risk assessment within this population.

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