Blood Pressure at 6 Months After Acute Myocardial Infarction and Outcomes at 2 Years: The Perils Associated With Excessively Low Blood Pressures
- Authors
- Song, Pil Sang; Lee, Seung Hun; Jeon, Ki-Hyun; Hahn, Joo-Yong; Hur, Seung-Ho; Rha, Seung-Woon; Yoon, Chang-Hwan; Jeong, Myung Ho; Jeong, Jin-Ok; Seong, In-Whan; Song, Young Bin; Gwon, Hyeon-Cheol
- Issue Date
- Oct-2020
- Publisher
- ELSEVIER SCIENCE INC
- Citation
- CANADIAN JOURNAL OF CARDIOLOGY, v.36, no.10, pp.1641 - 1648
- Indexed
- SCIE
SCOPUS
- Journal Title
- CANADIAN JOURNAL OF CARDIOLOGY
- Volume
- 36
- Number
- 10
- Start Page
- 1641
- End Page
- 1648
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/52600
- DOI
- 10.1016/j.cjca.2020.01.026
- ISSN
- 0828-282X
- Abstract
- Background: This study aimed to determine the association between achieved blood pressure at 6-month follow-up and cardiovascular outcomes at 2 years in patients treated with [3-blockers and reninangiotensin-aldosterone blockers after acute myocardial infarction (AMI). Methods: We analyzed data from 5503 patients enrolled in the national AMI registry. Patients with myocardial reinfarction (MrI), rehospitalization for heart failure (rHHF), or stroke before 6-month follow-up were excluded. Achieved blood pressures were categorized into 10-mm Hg increments. The primary outcome was all-cause death. The secondary outcome was a composite of all-cause death, MrI, and rHHF. Hazard ratios (HRs) were estimated with multivariable-adjusted Cox hazards models using 125to 134-mm Hg systolic blood pressure (SBP) and 75to 84-mm Hg diastolic blood pressure (DBP) subgroups as reference. Results: After a median follow-up of 2.1 years, SBP < 115 mm Hg was associated with increased risks for all-cause death (adjusted HR: 2.202 [1.158-4.188]) and for a composite outcome (HR: 1.682 [1.075-2.630]). Likewise, DBP < 75 mm Hg tended to be associated with an increase in all-cause death (HR: 2.078 [0.998-4.327] for DBP of 65 to 74 mm Hg; HR: 2.610 [1.256-5.423] for DBP < 65 mm Hg). Even in patients <75 years, the risk of a composite outcome was increased for DBP < 65 mm Hg (HR: 2.492 [1.401-4.434]). Conclusions: Low blood pressure achieved with beta-blocker and renin-angiotensin-aldosterone blocker at 6 months was associated with an increased risk of all-cause mortality independently of confounding factors in patients with AMI. This finding suggests that caution should be taken for patients with AMI who use blood-pressure-lowering treatments.
- Files in This Item
- There are no files associated with this item.
- Appears in
Collections - Graduate School > Department of Biomedical Sciences > 1. Journal Articles
![qrcode](https://api.qrserver.com/v1/create-qr-code/?size=55x55&data=https://scholar.korea.ac.kr/handle/2021.sw.korea/52600)
Items in ScholarWorks are protected by copyright, with all rights reserved, unless otherwise indicated.