Document Detail

Meta-analysis of adverse cardiovascular outcomes associated with antecedent hypertension after myocardial infarction.
MedLine Citation:
PMID:  19576336     Owner:  NLM     Status:  MEDLINE    
The aim of this study was to investigate the association of antecedent hypertension with adverse cardiovascular outcomes after myocardial infarction. A search of Medline and EMBASE was supplemented by manual searches of the bibliographies of key retrieved reports. The studies were included if they reported antecedent hypertension as a risk factor for adverse outcomes (death, stroke, congestive heart failure, recurrent myocardial infarction) in survivors of myocardial infarctions. Relative risks (RRs) were pooled using a random-effects model, and the robustness of the pooled RRs was evaluated in sensitivity analyses. Cumulative meta-analysis, by chronologic year of study beginning, was also performed. The search yielded 17 studies (n = 56,748 participants) that reported antecedent hypertension with adverse outcomes for survivors of myocardial infarctions. Randomized clinical trials (n = 8) were pooled separately from cohort studies (n = 9). For randomized clinical trials, the pooled RRs were 1.19 (95% confidence interval [CI] 1.13 to 1.26) for all-cause mortality and 1.29 (95% CI 1.09 to 1.53) for cardiovascular disease mortality. For cohort studies, the pooled RRs were 1.46 (95% CI 1.34 to 1.61) for all-cause mortality and 1.54 (95% CI 1.22 to 1.93) for cardiovascular disease mortality. Antecedent hypertension was also consistently associated with an increased risk for stroke, congestive heart failure, and recurrent myocardial infarction. Pooled estimates were robust in sensitivity analysis. In conclusion, antecedent hypertension was associated with adverse outcomes for survivors of myocardial infarctions, the association of antecedent hypertension with all-cause mortality outcomes decreased over time, and this decreased association reflects improved treatment and management of hypertension in more recent years.
Guanmin Chen; Brenda Hemmelgarn; Sami Alhaider; Hude Quan; Norm Campbell; Doreen Rabi
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't; Review     Date:  2009-05-04
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-06     Completed Date:  2009-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  141-7     Citation Subset:  AIM; IM    
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
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MeSH Terms
Cardiovascular Diseases / etiology,  mortality
Confidence Intervals
Hypertension / complications*,  drug therapy,  mortality
Middle Aged
Myocardial Infarction / complications,  drug therapy,  mortality*
Odds Ratio
Risk Assessment
Survival Analysis
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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