Amar J, Chamontin B, Ferriéres J, Danchin N, Grenier O, Cantet C, Cambou J-P
Service de Médecine et d'Hypertension Artérielle, CHU Purpan, Toulouse, France.
Heart. 2002 Dec;88(6):587-91. doi: 10.1136/heart.88.6.587.
To assess hypertension control in patients admitted to hospital for an acute coronary event and to investigate the influence on prognosis of controlling hypertension before hospital discharge.
Multicentre retrospective cohort study.
The medical records were examined of all patients admitted in 77 cardiological centres on January 1998 for myocardial infarction or unstable angina and who survived. Clinical characteristics, blood pressure at hospital discharge, and cardiovascular events during a six month follow up were recorded.
Cardiovascular deaths and non-fatal myocardial infarction.
Data were available in 1247 patients. At discharge, 411 (32.9%) had uncontrolled hypertension; among these, 276 (22.1%) were uncontrolled on the basis of systolic blood pressure alone. Forty three cardiovascular deaths and 20 non-fatal myocardial infarcts occurred during follow up. In a multivariate analysis, age, left ventricular ejection fraction, previous history of cardiovascular disease, and isolated systolic hypertension (odds ratio 1.9, 95% confidence interval 1.07 to 3.37) were associated with the outcome.
22.1% of patients admitted to hospital for an acute coronary syndrome have uncontrolled isolated systolic hypertension on discharge. This appears to be an independent predictor of cardiovascular outcome.
评估因急性冠脉事件入院患者的高血压控制情况，并调查出院前控制高血压对预后的影响。
多中心回顾性队列研究。
查阅了1998年1月在77个心脏病中心因心肌梗死或不稳定型心绞痛入院且存活的所有患者的病历。记录临床特征、出院时血压以及6个月随访期间的心血管事件。
心血管死亡和非致命性心肌梗死。
1247例患者有可用数据。出院时，411例（32.9%）患者高血压未得到控制；其中，276例（22.1%）仅收缩压未得到控制。随访期间发生43例心血管死亡和20例非致命性心肌梗死。多变量分析显示，年龄、左心室射血分数、心血管疾病既往史以及单纯收缩期高血压（比值比1.9，95%置信区间1.07至3.37）与结局相关。
因急性冠脉综合征入院的患者中，22.1%出院时单纯收缩期高血压未得到控制。这似乎是心血管结局的一个独立预测因素。
