Effects of systolic blood pressure and antihypertensive medications on individuals with ST-elevation myocardial infarction

Background To assess the associations of in-hospital antihypertensive medication use, admission systolic blood pressure (SBP), and 30-day outcome in individuals with ST-elevation myocardial infarction (STEMI). Methods STEMI cases treated in the Affiliated Hospital of Xuzhou Medical University between June 2010 and July 2021 were retrospectively analyzed. The primary outcome was 30-day all-cause mortality. Multivariate logistic regression analysis was performed to evaluate the associations of the number of used antihypertensive medications on 30-day mortality with admission SBP. Results Totally 7510 individuals with STEMI were included. After adjustment for baseline variables, SBP (OR = 1.12, 95%CI 1.08–1.19; P < 0.001), DBP (per 10-mmHg higher, OR = 1.14, 95%CI 1.04–1.22; P = 0.003), age (OR = 1.77, 95%CI 1.62–1.93; P < 0.001), male sex (OR = 1.56, 95%CI 1.31–1.86; P < 0.001), heart rate (OR = 1.19, 95%CI 1.11–1.22; P < 0.001), history of diabetes (OR = 1.50, 95%CI 1.18–1.91; P = 0.001), history of stroke (OR = 1.35, 95%CI 1.05–1.74; P = 0.002), Killip classes II-IV (ORs = 0.30–0.43, all P < 0.01), statin use (OR = 0.54, 95%CI 0.45–0.64; P < 0.001), nitrate use (OR = 0.70, 95%CI 0.53–0.92; P = 0.01), and use of a antihypertensive agent (OR = 9.91, 95%CI 3.86–25.48; P < 0.001) were independent predictors of 30-day mortality. Conclusions The number of antihypertensive medications during hospitalization has a significant association with 30-day mortality in Chinese individuals with STEMI without reperfusion. Trial registration: Not applicable.