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Hypertension is the leading modifiable risk factor for global cardiovascular disease, responsible for an estimated 10.8 million deaths and more than 200 million disability-adjusted life years annually.1 Despite the availability of effective pharmacological and lifestyle interventions, prevalence continues to rise, particularly in low- and middle-income countries (LMICs), where over three-quarters of all cases now occur.2 The condition’s […]

Role of optimal medication given to patients with hypertension and ischemic heart disease prior to an acute coronary syndrome

Călin Pop, Roberta Florescu, Claudia Matei, Lavinia Pop, Viorel Manea, Coralia Cotoraci, Liana Mos, Antoniu Petris
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Published Online: Aug 23rd 2018 Heart International. 2017;12(1):e18-e23 DOI: https://doi.org/10.5301/heartint.5000237
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Abstract

Overview

Introduction.
Administering optimal cardiovascular medication (OCM) to patients with hypertension (HBP) and
ischemic heart disease (IHD) lowers cardiovascular morbidity and mortality.
The main objective of this study was to compare in-hospital cardiac mortality among patients with HBP and/or
IHD, treated or untreated with OCM, who developed a first episode of acute coronary syndrome (ACS).
Methods.
The study was carried out retrospectively and included patients admitted with a first episode of ACS
between 2013 and 2016. The patients were divided into three groups: those with HBP, IHD, and a history of HBP +
IHD. Patients were then divided into two subgroups: subgroup A consisted of patients undergoing optimal anti-
ischemic and/or antihypertensive therapy, while subgroup B consisted of patients without OCM.
Results.
This analysis comprised 1096 patients. Mean age was 64.3 ± 18 years. There were 581 patients in subgroup A – 53%, and 515 patients in subgroup B – 47%. Total cardiac mortality was 9.98%, different depending
on the groups and subgroups studied: HBP group total – 7%, subgroup A – 5.1%, significantly lower compared
to subgroup B – 9.4% (p = 0.05); IHD group total – 12.2%, subgroup A – 9.07%, significantly lower compared to
subgroup B – 15.8% (p = 0.05); HBP + IHD group total – 14.35%, subgroup A – 9.9%, significantly lower compared
to subgroup B – 18.8% (p = 0.05).
Conclusions.
The lack of OCM in patients with HBP and/or IHD is correlated to a significant increase in in-hospital
cardiac mortality among patients who develop a first-episode ACS.

Keywords

Acute coronary syndrome, Cardiac mortality, Hypertension, Ischemic heart disease, Optimal cardio – vascular medication

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Article Information

Disclosure

Financial support: No grants or funding have been received for this study.

Correspondence

Călin Pop George Cosbuc Street nr 31 Baia Mare, Romania medicbm@yahoo.com

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