High systolic BP in patients with chest pain linked with favorable prognosis

Mar 23, 2010

New research finds that there is an inverse association between the level of supine (lying face up) systolic blood pressure measured on admission to an intensive care unit for acute chest pain and risk of death at one year, with those patients having high systolic blood pressure having a better prognosis after a year, according to a study in the March 24/31 issue of JAMA.

High blood pressure (BP) when measured after a resting period is among the best studied and established risk factors for cardiovascular disease, according to background information in the article. "However, little is known about the relationship between BP under acute stress, such as in acute chest pain, and subsequent mortality," the authors write.

Fredrik H. Nystrom, M.D., Ph.D., and colleagues from Linkoping University, Linkoping, Sweden, examined the death rate in relation to supine systolic BP measured at admission to an (ICU) for chest pain from 1997 through 2007. The study included analysis of data from 119,151 patients in a registry that includes all Swedish hospitals. Results from this study were presented according to systolic BP quartiles: Q1, less than 128 mm Hg; Q2, from 128 to 144 mm Hg; Q3, from 145 to 162 mm Hg; and Q4, at or above 163 mm Hg. Average follow-up time was 2.5 years.

The researchers found that the one-year mortality rate, after adjustment for various factors, showed that participants in Q1 of systolic BP had highest risk for death; conversely, patients in Q4 had the best prognosis. "Corresponding adjusted absolute risks were a 21.7 percent lower absolute risk for death within 1 year for patients in Q4 compared with Q2. The mortality risk was 15.2 percent lower for patients in Q3 compared with Q2 while the risk for patients in Q1 was 40.3 percent higher for mortality compared with that in Q2," the authors write.

"High supine systolic BP measured in patients with acute chest pain was associated with a favorable 1-year prognosis," they write. "There is an inverse association between admission supine systolic BP and 1-year mortality rate in patients admitted to the medical ICU for chest pain. This finding also applies to those patients who are diagnosed with ischemic heart disease and those who eventually develop [heart attack]."

Explore further: Ebola reveals shortcomings of African solidarity

More information: JAMA. 2010;303[12]:1167-1172.

add to favorites email to friend print save as pdf

Related Stories

Recommended for you

Ebola reveals shortcomings of African solidarity

4 hours ago

As Africa's leaders meet in Ethiopia to discuss the Ebola crisis, expectations of firm action will be tempered by criticism over the continent's poor record in the early stages of the epidemic.

Second bird flu case confirmed in Canada

20 hours ago

The husband of a Canadian who was diagnosed earlier this week with bird flu after returning from a trip to China has also tested positive for the virus, health officials said Friday.

What exactly is coronavirus?

Jan 30, 2015

The conflicts in Syria and Iraq are straining public health systems and public health efforts meant to prevent and detect the spread of infectious diseases. This is generating a "perfect storm" of conditions for outbreaks. Among the infections raising concern is Middle East Respiratory Syndrome, caused by a type of coronavirus, which emerged in 2012. ...

Scientists find Ebola virus is mutating

Jan 30, 2015

(Medical Xpress)—Researchers working at Institut Pasteur in France have found that the Ebola virus is mutating "a lot" causing concern in the African countries where the virus has killed over eight thous ...

User comments : 0

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.