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

Heart International. 2017;12(1):e18-e23

Abstract:

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
Disclosure: Financial support: No grants or funding have been received for this study.
Conflict of interest: None of the authors has financial interest related to this study to disclose.
Accepted: September 18, 2017 Published Online: October 14, 2017
Correspondence: Călin Pop George Cosbuc Street nr 31 Baia Mare, Romania medicbm@yahoo.com

Keywords: Acute coronary syndrome, Cardiac mortality, Hypertension, Ischemic heart disease, Optimal cardio - vascular medication