Document Type : Original Article

Authors

1 Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran

2 Master of science, Cardiovascular Research Center, Imam Ali Hospital, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran

3 Cardiovascular Research Center, Imam Ali Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran

4 Cardiovascular Research Center, Imam Ali Hospital, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran

10.48305/arya.2023.41248.2859

Abstract

Background: Hypertension is a risk factor for cardiovascular diseases, but low admission systolic blood pressure (SBP) has been suggested as a predictor for increased mortality. So the aim of the current study was to investigate the relationship between admission SBP and one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI).

Methods: This was a registry-based cohort study of STEMI patients from July 2018-December 2019. Patients were stratified by admission SBP into three groups: normal (˂112 mm Hg), elevated (112–140 mm Hg) and hypertension (≥140 mm Hg) and followed for one year. Cox proportional models were used to estimate crude and full-adjusted hazard ratios with 95% confidence intervals (HR, 95%CI).

Results: From the cohort of 1159 patients, 108(9.32%) died during one year. Among the 1159 patients, 276 had normal admission SBP, 338 patients presented with elevated admission SBP and 545 patients presented with hypertension. Patients with hypertension had a high-risk profile, such as hyperlipidemia, BMI, LDL, anterior MI and more often female. Crude and full-adjusted HR (95%CI) for the associations of high admission SBP and mortality were 0.36(0.23-0.56) and 0.43 (0.23-0.81), respectively.

Conclusion: This study demonstrates an association between higher admission SBP and lower risk of one-year mortality in the STEMI patients. So, in contrast to the general population, where a direct linear relationship exists between SBP and the risk of future cardiovascular outcomes, in the acute setting, there is an inverse association between SBP and one-year mortality.

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