First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.
J Clin Hypertens (Greenwich). 2019 Aug;21(8):1135-1143. doi: 10.1111/jch.13622. Epub 2019 Jul 12.
Arterial hypertension is a well-established cardiovascular risk factor, and blood pressure (BP) control has largely improved the prognosis of hypertensive patients. A number of studies have assessed the role of BP levels in the prognosis of patients with acute coronary syndromes. Pathophysiologic links of hypertension to acute myocardial infarction (MI) include endothelial dysfunction, autonomic nervous system dysregulation, impaired vasoreactivity, and a genetic substrate. A history of hypertension is highly prevalent among patients presenting with MI, and some, but not all, studies have associated it with a worse prognosis. Some data support that low levels of admission and in-hospital BP may indicate an increased risk for subsequent events. Risk scores used in patients with MI have, therefore, included BP levels and a history of hypertension in their variables. Of note, good long-term BP control, ideally initiated prior to discharge, should be pursued in order to improve secondary prevention.
动脉高血压是一种明确的心血管风险因素，血压（BP）控制在很大程度上改善了高血压患者的预后。许多研究评估了 BP 水平在急性冠状动脉综合征患者预后中的作用。高血压与急性心肌梗死（MI）的病理生理联系包括内皮功能障碍、自主神经系统失调、血管反应性受损和遗传基础。高血压病史在 MI 患者中非常常见，一些（但不是全部）研究表明其与预后较差相关。一些数据支持入院和住院期间的 BP 水平较低可能预示着随后发生事件的风险增加。因此，在 MI 患者中使用的风险评分将 BP 水平和高血压病史纳入其变量。值得注意的是，应追求长期良好的 BP 控制，理想情况下在出院前开始，以改善二级预防。
