Non-ST Elevation Myocardial Infarction in Patients With Hypertensive Emergency
G Thiruvikrama Prakash1, Prafull Dhewle2, Subash Chandra Bose3
1Department of Cardiology, E. S. Hospital, Villupuram, IND.
Insights
Hypertensive emergencies in non-ST elevation myocardial infarction (NSTEMI) patients are linked to risk factors like age, smoking, and alcohol. Diabetes significantly impacts coronary artery disease in these high-cardiovascular-risk individuals.
Area of Science:
- Cardiology
- Diabetology
- Hypertension Research
Background:
- Hypertensive emergencies are critical cardiovascular events.
- Non-ST elevation myocardial infarction (NSTEMI) patients have higher hypertension rates than STEMI.
- Limited research exists on NSTEMI patients experiencing hypertensive emergencies, particularly concerning diabetes impact.
Purpose of the Study:
- To investigate the coronary artery disease profile in NSTEMI patients with hypertensive emergencies.
- To determine the influence of diabetes on the development of hypertensive emergencies in this cohort.
Main Methods:
- A study of 100 NSTEMI patients with hypertensive emergencies over 24 months.
- Patients were sub-grouped into diabetic and non-diabetic, with baseline characteristics, coronary, and renal angiograms recorded.
- Statistical analysis included chi-square and t-tests (P < 0.05 significance).
Main Results:
- The average age of presentation was 58 years; 48% of patients had diabetes.
- Diabetic patients showed more single-vessel disease (37.5%), while non-diabetics had more double-vessel disease (28.8%).
- Alcohol consumption (28%) and smoking (23%) were noted; 62.6% used combination drugs, and 46.9% were non-adherent.
Conclusions:
- Age, smoking, alcohol use, and medication non-adherence are associated with hypertensive emergencies in NSTEMI.
- Diabetes is significantly linked to unfavorable coronary anatomy in patients with NSTEMI and hypertensive emergencies.
Abstract:
Background Hypertensive emergencies represent high-cardiovascular-risk situations defined by severe increases in blood pressure. The prevalence of hypertension in non-ST elevation myocardial infarction (NSTEMI) is higher compared to STEMI and there is a lack of studies on NSTEMI patients with hypertensive emergencies. Patients with diabetes exhibited a higher rate of hypertensive emergencies. This study's primary aim was to investigate the coronary artery disease profile in hypertensive emergency patients with NSTEMI, and the secondary aim was to determine the impact of diabetes on the development of hypertensive emergencies. Methodology A total of 100 patients with NSTEMI and hypertensive emergency presenting to the hospital were enrolled in the study. The duration of the study was 24 months. The patients were also sub-grouped into diabetic and nondiabetic. Baseline characteristics were noted, and coronary angiogram and renal angiogram were also done. Based on variables, the chi-square test and t-test were employed to assess the significance. P-value < 0.05 was considered statistically significant. Results The mean age at presentation for patients with NSTEMI and hypertensive emergency was 58 years. Patients consuming alcohol were slightly higher (28, 28%) than those who smoked (23, 23%). Among all, 48 (48%) patients had diabetes. When considering the number of vessels, diabetic patients had more single-vessel diseases (18, 37.5%) and nondiabetic patients had more double-vessel diseases (15, 28.8%). The mean ejection fraction of the diabetic group was 56.1% ± 6.8% and the nondiabetic group was 54.2% ± 7.7%. Among all the patients, 52 (62.6%) used combination drugs, while 39 (46.9%) were on defaulter drugs. Conclusions Several risk factors like age, smoking, alcohol, and nonadherence to drugs were found to have an association with the occurrence of hypertensive emergency. Diabetes was found to be significantly associated with unfavorable coronary anatomy among the population.
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