Prevalence of Myocardial Injury and Myocardial Infarction in Patients with a Hypertensive Emergency: A Systematic Review

Myocardial injury and myocardial infarction can complicate a hypertensive emergency, and both are associated with poor prognosis. However, little is known about the prevalence of myocardial injury and the different subtypes of myocardial infarction in patients with hypertensive emergencies. This systematic review aims to determine the prevalence of myocardial infarction and its subtypes, and the prevalence of myocardial injury in patients with hypertensive emergencies following the PRISMA guideline. A systematic search of PubMed, Web of Science, and EBSCOHost (MEDLINE) databases was carried out from inception to identify relevant articles. A total of 18 studies involving 7545 patients with a hypertensive emergency were included. Fifteen (83.3%) studies reported on the prevalence of myocardial infarction ranging from 3.6% to 59.6%, but only two studies specifically indicated the prevalence of ST-elevation and non-ST-elevation myocardial infarction. The prevalence of myocardial injury was obtained in three studies (16.7%) and ranged from 15% to 63%. Despite being common, very few studies reported myocardial injury and the subtypes of myocardial infarction among patients presenting with a hypertensive emergency, highlighting the need for more research in this area which will provide pertinent data to guide patient management and identify those at increased risk of major adverse cardiovascular events.

[1]  A. Dzudie,et al.  Gender Differences in Cardiovascular Risk Factors, Clinical Presentation, and Outcome of Patients Admitted with a Hypertensive Crisis at the Buea Regional Hospital, Cameroon , 2022, International journal of hypertension.

[2]  Jinho Shin,et al.  Clinical implications of cardiac troponin-I in patients with hypertensive crisis visiting the emergency department , 2022, Annals of medicine.

[3]  P. Nihoyannopoulos,et al.  Profile and management of hypertensive urgencies and emergencies in the emergency cardiology department of a tertiary hospital: a 12-month registry. , 2021, European journal of preventive cardiology.

[4]  Sittichai Khamsai,et al.  Clinical treatment outcomes of hypertensive emergency patients: Results from the hypertension registry program in Northeastern Thailand , 2020, Journal of clinical hypertension.

[5]  E. Mayo-Wilson,et al.  PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews , 2020, BMJ.

[6]  Dorairaj Prabhakaran,et al.  2020 International Society of Hypertension global hypertension practice guidelines. , 2020, Journal of hypertension.

[7]  Dorairaj Prabhakaran,et al.  2020 International Society of Hypertension Global Hypertension Practice Guidelines. , 2020, Hypertension.

[8]  F. Veglio,et al.  Hypertensive emergencies and urgencies in emergency departments: a systematic review and meta-analysis. , 2020, Journal of hypertension.

[9]  George A. Koromia,et al.  Clinical Determinants of Myocardial Injury, Detectable and Serial Troponin Levels among Patients with Hypertensive Crisis , 2020, Cureus.

[10]  M. Muiesan,et al.  Hypertensive emergencies and urgencies: a single-centre experience in Northern Italy 2008-2015. , 2020, Journal of hypertension.

[11]  M. Vaduganathan,et al.  Misclassification of Myocardial Injury as Myocardial Infarction: Implications for Assessing Outcomes in Value-Based Programs. , 2019, JAMA cardiology.

[12]  Thomas Kahan,et al.  [2018 ESC/ESH Guidelines for the management of arterial hypertension]. , 2019, Kardiologia polska.

[13]  A. Cremer,et al.  Malignant hypertension: diagnosis, treatment and prognosis with experience from the Bordeaux cohort , 2019, Journal of hypertension.

[14]  W. Spiering,et al.  [2018 ESC/ESH Guidelines for the management of arterial hypertension. The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH)]. , 2018, Giornale italiano di cardiologia.

[15]  Abdalazeem Ibrahem,et al.  Clinico-epidemiological characteristics and survival outcome of patients with hypertensive crisis at Kassala Hospital, Eastern Sudan , 2018, Journal of Clinical Intensive Care and Medicine.

[16]  Irina Benenson,et al.  Hypertensive emergencies in diabetic patients from predominantly African American urban communities , 2018, Clinical and experimental hypertension.

[17]  Kristian Thygesen,et al.  Fourth Universal Definition of Myocardial Infarction (2018). , 2018, Journal of the American College of Cardiology.

[18]  G. Lip,et al.  ESC Council on hypertension position document on the management of hypertensive emergencies. , 2018, European heart journal. Cardiovascular pharmacotherapy.

[19]  D. Newby,et al.  Long-Term Outcomes in Patients With Type 2 Myocardial Infarction and Myocardial Injury , 2017, Circulation.

[20]  A. Loundou,et al.  Hospital and out‐of‐hospital mortality in 670 hypertensive emergencies and urgencies , 2017, Journal of clinical hypertension.

[21]  Matthew W. Martinez,et al.  Trends in Hospitalization for Hypertensive Emergency, and Relationship of End-Organ Damage With In-Hospital Mortality , 2017, American journal of hypertension.

[22]  C. McNaughton,et al.  Trends in the Incidence of Hypertensive Emergencies in US Emergency Departments From 2006 to 2013 , 2016, Journal of the American Heart Association.

[23]  G. Lip,et al.  From malignant hypertension to hypertension-MOD: a modern definition for an old but still dangerous emergency , 2016, Journal of Human Hypertension.

[24]  K. Thygesen,et al.  Prognostic Impact of Myocardial Injury Related to Various Cardiac and Noncardiac Conditions. , 2016, The American journal of medicine.

[25]  K. Reynolds,et al.  Abstract 16828: Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-based Studies From 90 Countries , 2015, Circulation.

[26]  Linnea A. Polgreen,et al.  Increasing Trend in Admissions for Malignant Hypertension and Hypertensive Encephalopathy in the United States , 2015, Hypertension.

[27]  Jeroen J. Bax,et al.  The universal definition of myocardial infarction , 2015, Oxford Medicine Online.

[28]  G. Bruno,et al.  Hospital Admissions for Hypertensive Crisis in the Emergency Departments: A Large Multicenter Italian Study , 2014, PloS one.

[29]  H. González Pacheco,et al.  Patients With Hypertensive Crises Who Are Admitted to a Coronary Care Unit: Clinical Characteristics and Outcomes , 2013, Journal of clinical hypertension.

[30]  Ashish Aneja,et al.  Elevated troponin predicts long-term adverse cardiovascular outcomes in hypertensive crisis: a retrospective study , 2012, Journal of hypertension.

[31]  F. Blyth,et al.  Assessing risk of bias in prevalence studies: modification of an existing tool and evidence of interrater agreement. , 2012, Journal of clinical epidemiology.

[32]  J. Chalmers,et al.  Mortality patterns in hypertension , 2011, Journal of hypertension.

[33]  J. Mehta,et al.  Effect of Joint National Committee VII report on hospitalizations for hypertensive emergencies in the United States. , 2011, The American journal of cardiology.

[34]  Renan Oliveira Vaz-de-Melo,et al.  Hypertensive crisis: clinical–epidemiological profile , 2011, Hypertension Research.

[35]  L. Ruilope,et al.  Long-term renal survival in malignant hypertension. , 2010, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[36]  A. Amin,et al.  Practice patterns, outcomes, and end-organ dysfunction for patients with acute severe hypertension: the Studying the Treatment of Acute hyperTension (STAT) registry. , 2009, American heart journal.

[37]  J. P. Cipullo,et al.  Hypertensive crisis profile. Prevalence and clinical presentation. , 2004, Arquivos brasileiros de cardiologia.

[38]  J. Gore,et al.  Clinical study: myocardial infarctionTwenty-two year (1975 to 1997) trends in the incidence, in-hospital and long-term case fatality rates from initial q-wave and non-q-wave myocardial infarction: a multi-hospital, community-wide perspective☆ , 2001 .

[39]  M. Beevers,et al.  The failure of malignant hypertension to decline: a survey of 24 years' experience in a multiracial population in England , 1994, Journal of hypertension.

[40]  M. Marchisio,et al.  Hypertensive urgencies and emergencies. Prevalence and clinical presentation. , 1996, Hypertension.