Herlitz J, Karlson B W, Richter A, Wiklund O, Jablonskiene D, Hjalmarson A
Department of Medicine I, Sahlgrenska Hospital, Gothenburg, Sweden.
J Hypertens. 1992 Oct;10(10):1265-71. doi: 10.1097/00004872-199210000-00022.
A previous history of hypertension is overrepresented among patients with ischaemic heart disease. The present study aims at describing the influence of a previous history of hypertension upon the prognosis among patients hospitalized due to acute myocardial infarction.
Patients were followed for 1 year. Mortality and morbidity are described during hospitalization and after discharge from hospital.
Sahlgrenska Hospital, serving half of the area of Gothenburg in Sweden.
All patients admitted to Sahlgrenska Hospital during 21 months due to acute myocardial infarction regardless of age and whether they were admitted to the coronary care unit.
Among all patients with confirmed acute myocardial infarction (n = 917) a previous history of hypertension was reported in 324 patients. Hypertensives more frequently had a previous history of acute myocardial infarction, angina pectoris, congestive heart failure and diabetes mellitus. Their mortality during hospitalization was similar to that in normotensives. However, the total mortality during 1 year of follow-up was 35% in hypertensives and 25% for normotensives (P < 0.01), and a previous history of hypertension was an independent risk indicator for death after discharge from hospital. Place and mode of death appeared similar in normotensives and hypertensives. Reinfarction was twice as common in hypertensives as in normotensives, and a previous history of hypertension was an independent risk indicator for reinfarction.
Among patients with acute myocardial infarction a previous history of hypertension indicates a poor prognosis, one-third of patients dying and one-quarter developing reinfarction during the first year after onset of acute myocardial infarction.
缺血性心脏病患者中高血压病史的比例过高。本研究旨在描述高血压病史对因急性心肌梗死住院患者预后的影响。
对患者进行为期1年的随访。描述住院期间及出院后的死亡率和发病率。
瑞典哥德堡地区一半区域的萨尔格伦斯卡医院。
21个月内因急性心肌梗死入住萨尔格伦斯卡医院的所有患者，无论年龄大小及是否入住冠心病监护病房。
在所有确诊为急性心肌梗死的患者（n = 917）中，324例有高血压病史。高血压患者更常伴有急性心肌梗死、心绞痛、充血性心力衰竭和糖尿病病史。他们住院期间的死亡率与血压正常者相似。然而，随访1年期间，高血压患者的总死亡率为35%，血压正常者为25%（P < 0.01），高血压病史是出院后死亡的独立风险指标。血压正常者和高血压患者的死亡地点和死亡方式相似。高血压患者再梗死的发生率是血压正常者的两倍，高血压病史是再梗死的独立风险指标。
在急性心肌梗死患者中，高血压病史提示预后不良，三分之一的患者在急性心肌梗死发病后第一年内死亡，四分之一的患者发生再梗死。
