Hypertension and cardiac complications in normotensive myocardial infarction patients with elevated exercise blood...

Four hundred and sixty-two patients with uncomplicated transmural cardiac infarction were investigated to determine the influence of isolated exercise hypertension on the subsequent development of hypertension (group I, n = 180) and its clinical course (group II, n = 282). Of the infarcted patients with an elevated exercise blood pressure, 83% developed manifest hypertension within 5 years, compared with only 3% with normal exercise blood pressures. Within an observation period of 6 years, the cardiac infarction patients with exercise hypertension suffered a fourfold higher rate of complications than those with normal exercise blood pressures. With elevated exercise blood pressures the mortality rate was 26% and the reinfarction rate 16%, compared with only 5 and 4%, respectively, in patients with normal exercise blood pressure. In addition to the severity of coronary ischaemia and the degree of ventricular impairment, isolated exercise hypertension carried a further unfavourable prognosis.