Blood pressure at hospital discharge after acute coronary event

Objective: The difficulty in controlling hypertension in coronary patients has been underlined. The aim of the study was to assess blood pressure prof ile (BP) at hospital discharge in a large population of survivors of an acu te coronary syndrome. Design and methods: An observational study was conducted in France in 77 ca rdiological centers. The medical records of all patients admitted in these hospitals on January 1998 for a myocardial infarction or unstable angina an d who survived were studied. Clinical characteristics and BP at hospital di scharge were recorded. Patients with blood pressure greater than or equal t o 140/90 mmHg were considered as uncontrolled hypertensives (HT). Results: Data were available in 1327 of the 1394 patients recruited: at hos pital discharge, 344 patients (25.9%) were controlled and 431 (32.4%) were uncontrolled hypertensives. Among these patients, 406 (94.1%) had systolic blood pressure greater than or equal to 140 mmHg, 139 (32.2%) had diastolic blood pressure greater than or equal to 90 mmHg and 292 patients (67.7%) h ad systolic blood pressure greater than or equal to 140 mmHg and diastolic blood pressure < 90 mmHg. Pulse pressure in controlled hypertensives (51.02 +/- 10.93 mmHg) was quite similar to that in normotensives (47.81 +/- 9.84 mmHg) whereas pulse pressure was significantly higher in uncontrolled hype rtensives (65.86 +/- 13.29 mmHg). Conclusion: At hospital discharge after a coronary event, arterial hyperten sion is uncontrolled in 32.4% of patients mainly because of poor systolic b lood pressure control. Achieving normal blood pressure throughout the hospi talisation should improve long term blood pressure control, reduce pulse pr essure and improve the prognosis in this high risk population.