Does a history of diabetes mellitus adversely affect the outcome in hypertensive patients with acute chest pain?

BACKGROUND

We evaluated the impact of diabetes mellitus on the prognosis in hypertensive patients admitted to hospital as a result of acute chest pain.

PATIENTS

All patients in this study had a history of hypertension and were admitted to the Emergency Department at Sahlgrenska Hospital, Göteborg, Sweden, complaining of chest pain, or other symptoms suggestive of acute myocardial infarction, between 15 February 1986 and 9 November 1987.

METHODS

All patients were prospectively registered on admission to the Emergency Department and followed for 1 year in terms of mortality and morbidity.

RESULTS

Of the 1274 patients who fulfilled the inclusion criteria, 187 (15%) had a history of diabetes mellitus. The 1-year mortality rate for all hypertensive patients was 18%, whereas it was 24% for those who also had diabetes mellitus, and 16% for hypertensive patients without diabetes mellitus (P < 0.05). However, in a multivariate analysis considering age, sex, and history of cardiovascular diseases, the following appeared as independent predictors of death in the hypertensive patients: age (P < 0.001), a history of congestive heart failure (P < 0.001), and male sex (P < 0.01).

CONCLUSION

Hypertensive patients who were admitted to the Emergency Department of Sahlgrenska Hospital with acute chest pain had a poor prognosis, which was even worse if they also had a history of diabetes mellitus. The relationship between diabetes mellitus and hypertension could not, however, be clearly defined.