Methods; Among 13,104 patients who enrolled in nationwide AMI database of South Korea, the KAMIR-NIH Registry, 4,216 hypertensive patients, who survived the initial attack and had 6-month BP data, were selected in this study. They were divided into six systolic or diastolic BP groups according to BP levels (Table).
Results; Lowest 6-month systolic BP group of <110 mmHg or lowest 6-month diastolic BP group of <65 mmHg showed the highest re-HF at 1-year (6.9 ± 1.1% and 8.0 ± 1.0%, respectively) (Figure). On multivariate Cox-proportional hazard analysis, patients with lowest systolic BP (OR; 2.01, 95% CI; 1.17-3.44, p=0.011) or lowest diastolic BP (OR; 4.04, 95% CI; 1.84-8.97, p=0.001) had the highest re-HF at 1-year compared with optimal level of BP. Higher diastolic BP than optimal level also increased re-HF. Even after excluding patients with re-HF before 6 months, patients with lowest systolic BP (OR; 2.09, 95% CI; 1.19-3.67, p=0.010) or lowest diastolic BP (OR; 3.98, 95% CI; 1.80-8.79, p=0.001) at 6- month showed the greatest risk for re-HF at 1-year.
Conclusions; Systolic BP lower than optimal level, and diastolic BP lower or higher than that at 6-month, increased re-HF at 1-year in hypertensive patients with AMI.