BLOOD-PRESSURE AND OTHER RISK-FACTORS BEFORE THE ONSET OF MYOCARDIAL-INFARCTION IN HYPERTENSIVE PATIENTS

To investigate blood pressure (BP) as well as other risk factors befor e the onset of myocardial infarction in hypertensive patients, we anal ysed the BP and metabolic variables in 94 hypertensive patients who ha d been followed up in our out-patient clinic before the first onset (M 1 group; n = 42, 69 +/- 1 years, mean +/- s.e.) or the recurrent onset (M2 group; n = 52, 69 +/- 1 years) of myocardial infarction. Ninety-f our hypertensive outpatients who had no history of serious cardiovascu lar diseases (C group) were also recruited for an age- and sex-matched case-control study. The majority of the patients were taking anti-hyp ertensive drugs (M1: 90%; M2: 98%; C: 90%). The average BP values for 1 year before the onset of myocardial infarction were used for the ana lysis. The BPs before the onset of myocardial infarction were 147 +/- 2 mm Hg systole and 81 +/- 2 mm Hg diastole in the M1 group, and 141 /- 2 mm Hg systole and 78 +/- 1 mm Hg diastole in the M2 group, while those of the C group were 146 +/- 1 mm Hg systole and 84 +/- 1 mm Hg d iastole. The diastolic BP of the M2 group was significantly lower than that of the C group (P < 0.0001). In patients aged greater than or eq ual to 69 years, the diastolic BP of the M1 and M2 groups (M1: 77 +/- 1 mm Hg; M2: 75 +/- 1 mm Hg) were significantly lower than that of the C group (83 +/- 1 mm Hg). The fasting blood glucose of the M1 and M2 groups was higher than that of the C group. The serum HDL cholesterol of the M1 group was lower than that of the other groups. These results suggest that, in addition to glucose and lipid metabolism disorders, low diastolic BP is associated with the onset of myocardial infarction , especially in reinfarction and in elderly hypertensive patients.