Related Experiment Videos
Hypertension control and the risk of myocardial infarction and stroke: a population-based study
K A al-Roomi1, R F Heller, J Wlodarczyk
1Centre for Clinical Epidemiology and Biostatistics, Royal Newcastle Hospital, NSW.
Insights
Hypertension increases the risk of acute myocardial infarction (AMI) and stroke. Poor blood pressure control, even with treatment, is linked to higher event rates, suggesting hypertension management is crucial for cardiovascular health.
Area of Science:
- Cardiology
- Neurology
- Public Health
Background:
- Hypertension is a significant risk factor for cardiovascular diseases.
- Effective blood pressure control is essential for preventing adverse events.
Purpose of the Study:
- To investigate the role of hypertension and blood pressure control in the occurrence of acute myocardial infarction (AMI) and stroke.
- To assess the association between treated hypertension and cardiovascular outcomes in adults aged 35-69.
Main Methods:
- A population-based case-control study was conducted in the Hunter Region.
- Cases of first-time AMI or stroke were compared with randomly selected control subjects.
- Blood pressure data was collected from general practitioner records for treated hypertensive individuals.
Main Results:
- Individuals with AMI (37%) and stroke (51%) were more likely to be treated for hypertension than controls (20%).
- Among treated hypertensive patients, those who experienced AMI or stroke had higher last recorded blood pressure levels compared to controls.
- A trend suggested higher risk with diastolic blood pressure <80 mmHg, though not statistically significant.
Conclusions:
- The presence of hypertension and inadequate blood pressure control are associated with increased risk of AMI and stroke.
- Findings suggest that optimizing hypertension management may be critical for primary prevention of AMI and stroke.
Abstract:
A population-based case-control study was performed to determine the importance of the presence of hypertension and the control of blood pressure level during treatment for hypertension on the occurrence of acute myocardial infarction (AMI) and stroke in persons aged 35-69 years in the Hunter Region community. Patients with a first episode of AMI or stroke were identified from community-based heart attack and stroke registers and compared with control subjects obtained from a random population sample from the same community. Twenty per cent of control subjects were currently receiving treatment for hypertension compared with 37% of patients with myocardial infarction (odds ratio adjusted for age, sex and several other possible confounding variables, 2.6; 95% confidence interval (CI), 1.9-3.4) and 51% of patients with stroke (adjusted odds ratio, 3.5; 95% CI, 2.3-54). Among those who had ever been told they had hypertension, 71%, 73% and 59% of patients with AMI, patients with stroke and control subjects, respectively, were receiving treatment at the time of the AMI or the stroke or at the time of the survey (control subjects). For those receiving treatment for hypertension, blood pressure levels were obtained from the records of their general practitioner. Despite similar pretreatment levels the last recorded blood pressure level (either before the survey of the development of AMI or stroke) was higher among those who developed AMI or stroke than those in the control group. Those with a treated diastolic blood pressure of less than 80 mmHg appeared to be at a higher risk of both AMI and stroke than those with a treated diastolic blood pressure level of 80-89 mmHg, but the difference was not statistically significant. Randomised controlled trials do not show a reduction in rates of AMI in response to a reduction of blood pressure. Nevertheless our findings suggest that the presence of hypertension and poor control of blood pressure levels despite treatment may be important aetiologically both for AMI and stroke occurrence.