Document Detail

Hypertension and acute myocardial infarction: an overview.
MedLine Citation:
PMID:  22317927     Owner:  NLM     Status:  Publisher    
History of hypertension is a frequent finding in patients with acute myocardial infarction (AMI) and its recurring association with female sex, diabetes, older age, less frequent smoking and more frequent vascular comorbidities composes a risk profile quite distinctive from the normotensive ischemic counterpart.Antecedent hypertension associates with higher rates of death and morbid events both during the early and long-term course of AMI, particularly if complicated by left ventricular dysfunction and/or congestive heart failure. Renin-angiotensin-aldosterone system blockade, through either angiotensin-converting enzyme inhibition, angiotensin II receptor blockade or aldosterone antagonism, exerts particular benefits in that high-risk hypertensive subgroup.In contrast to the negative implications carried by antecedent hypertension, higher systolic pressure at the onset of chest pain associates with lower mortality within 1 year from coronary occlusion, whereas increased blood pressure recorded after hemodynamic stabilization from the acute ischemic event bears inconsistent relationships with recurring coronary events in the long-term follow-up.Whether antihypertensive treatment in post-AMI hypertensive patients prevents ischemic relapses is uncertain. As a matter of fact, excessive diastolic pressure drops may jeopardize coronary perfusion and predispose to new acute coronary events, although the precise cause-effect mechanisms underlying this phenomenon need further evaluation.
Roberto Pedrinelli; Piercarlo Ballo; Cesare Fiorentini; Silvia Denti; Maurizio Galderisi; Antonello Ganau; Giuseppe Germanò; Pasquale Innelli; Anna Paini; Stefano Perlini; Massimo Salvetti; Valerio Zacà;
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Publication Detail:
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  13     ISSN:  1558-2035     ISO Abbreviation:  -     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-2-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  194-202     Citation Subset:  -    
Dipartimento Cardio Toracico e Vascolare, Universita' Di Pisa, 56100 Pisa, Italy.
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