A history of hypertension in patients with acute myocardial infarction was not significantly associated with average in-hospital mortality after adjustment (OR 0.92; 95% CI 0.83-1.02; p=0.099).
Observational (n=58,499)
Yes
Does a history of hypertension affect in-hospital and 1-year mortality in patients with acute myocardial infarction?
After adjusting for baseline differences, a history of hypertension does not significantly impact in-hospital or 1-year mortality in patients presenting with acute myocardial infarction.
Odds Ratio: 0.92 (95% CI 0.83–1.02)
Absolute Event Rate: 5.5% vs 3.4%
p-value: p=0.099
Objective: Previous studies have reported conflicting findings regarding short-term outcomes in patients with acute myocardial infarction (AMI) with and without a history of hypertension. We aimed to analyze mortality trends according to a history of hypertension.Design and method: We included all AMI patients enrolled in the Swiss Acute Myocardial Infarction (AMIS) Plus registry between 2000 and 2025 with data on a history of hypertension. Observed mortality rates per admission year were plotted according to hypertension including smoothed trend lines. The adjusted plot was modelled with a multivariable logistic regression including a natural cubic spline for admission year. In a subgroup of patients with available 1-year-follow-up, we analyzed the impact of hypertension on 1-year mortality. Results: Patients with hypertension (n=36,679, 62.7%)) were older (median (IQR) 70.1 (60.3,78.6) vs. 60.4 (51.9, 70.8)) more often women (29.4% vs. 21.0%), had more often a NSTEMI (46.3% vs. 35.0%), had a higher rate of a Killip class >2 at admission (7.7% vs. 5.1%) and a higher rate of a Charlson Comorbidity index>1 (30.1% vs. 11.2%). Crude in-hospital mortality was higher in patients with hypertension (5.5% vs. 3.4%). Unadjusted analysis revealed a decreasing trend for mortality in both groups (p for both 2 and CCI>1 we observed a paradoxically lower mortality for patients with hypertension in the first years of the observation period but a very similar mortality afterwards. The average in-hospital mortality between 2000-2025 showed no significant difference between patients with and without hypertension after adjustment (OR 0.92, 95% CI 0.83-1.02, p=0.099). In a subanalysis of patients with available 1-year follow up (N=13,874) we found a higher crude 1-year mortality for patients with hypertension (4.1% vs. 2.1%). However, after adjustment for age, sex, STEMI/NSTEMI, CCI>1, Killip class>2 and admission year, the difference remained not significant (OR 0.93, 95%CI 0.73-1.17, p=0.521). Conclusions: Our data suggests that nowadays, short term- and 1-year mortality for AMI patients with and without hypertension are similar after adjustment for differences in characteristics.
Foster-Witassek et al. (Fri,) conducted a observational in Acute myocardial infarction (n=58,499). History of hypertension vs. No history of hypertension was evaluated on Average in-hospital mortality (OR 0.92, 95% CI 0.83-1.02, p=0.099). A history of hypertension in patients with acute myocardial infarction was not significantly associated with average in-hospital mortality after adjustment (OR 0.92; 95% CI 0.83-1.02; p=0.099).