PMID: 8967669Dec 1, 1996Paper

Relation of increased arterial blood pressure to mortality and stroke in the context of contemporary thrombolytic therapy for acute myocardial infarction. A randomized trial. GUSTO-I Investigators

Annals of Internal Medicine
P AylwardE J Topol

Abstract

Despite concern that hypertension increases the risk for intracranial hemorrhage during thrombolysis for acute myocardial infarction, the exact nature of the risk remains unclear. To assess the effects of previous hypertension and blood pressure at study entry on the outcomes of patients who had acute myocardial infarction and received thrombolysis. Randomized trial. 1081 hospitals in 15 countries. 41,021 patients who had myocardial infarction accompanied by ST-segment elevation and who presented to hospitals within 6 hours of symptom onset. One of four thrombolytic regimens. Mortality, stroke subtypes, and death plus disabling stroke in patients with previous hypertension and as functions of blood pressure at entry. Logistic regression analysis of relations among blood pressure at entry, baseline characteristics, and treatment effects. The incidence of total stroke and intracranial hemorrhage increased as systolic blood pressure at entry increased and was particularly high for systolic pressures of about 175 mm Hg or more (incidence of total stroke, 3.4% compared with 1.17% for pressures between 100 and 124 mm Hg). Patients who had systolic blood pressure of 175 mm Hg or more at entry and who received accelerated alteplase the...Continue Reading

Citations

Jun 30, 2000·Drugs & Aging·U Priglinger, K Huber
Jul 13, 2011·International Journal of Hypertension·Claudio PicarielloSerafina Valente
Nov 29, 2014·American Journal of Hypertension·Jin Sup ParkUNKNOWN Korea Working Group on Myocardial Infarction Investigators
Dec 13, 2006·The American Journal of Emergency Medicine·Adnan I QureshiAlluru S Reddi
Oct 13, 2017·Korean Journal of Ophthalmology : KJO·Elias Khalili PourMohammad Riazi Esfahani
Feb 8, 2014·Journal of Clinical Pharmacology·Efrén Martínez-QuintanaAntonio Tugores
May 21, 1998·Circulation·H D White, F J Van de Werf
Feb 10, 2012·Journal of Cardiovascular Medicine·Roberto PedrinelliUNKNOWN Gruppo di Studio Ipertensione e Cuore, Societa’ Italiana di Cardiologia
Feb 24, 2001·Current Opinion in Cardiology·C K Wong, H D White
Apr 29, 2015·Journal of Hypertension·Paul ErneUNKNOWN AMIS Plus Investigators
Jul 23, 2003·Journal of Thrombosis and Haemostasis : JTH·J E Dalen

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