# Non-ST Elevation Myocardial Infarction in Patients With Hypertensive Emergency

## TL;DR

This study examines how hypertension emergencies affect patients with non-ST elevation heart attacks, finding that diabetes is linked to worse heart artery disease.

## Contribution

The study provides new insights into coronary artery disease profiles in NSTEMI patients with hypertensive emergencies, particularly highlighting the role of diabetes.

## Key findings

- Diabetic patients had more single-vessel coronary artery disease compared to nondiabetic patients.
- Nonadherence to drugs was observed in nearly half of the patients with hypertensive emergencies.
- Age, smoking, alcohol use, and drug nonadherence were associated with hypertensive emergencies.

## Abstract

Background

Hypertensive emergencies represent high-cardiovascular-risk situations defined by severe increases in blood pressure. The prevalence of hypertension in non-ST elevation myocardial infarction (NSTEMI) is higher compared to STEMI and there is a lack of studies on NSTEMI patients with hypertensive emergencies. Patients with diabetes exhibited a higher rate of hypertensive emergencies. This study's primary aim was to investigate the coronary artery disease profile in hypertensive emergency patients with NSTEMI, and the secondary aim was to determine the impact of diabetes on the development of hypertensive emergencies.

Methodology

A total of 100 patients with NSTEMI and hypertensive emergency presenting to the hospital were enrolled in the study. The duration of the study was 24 months. The patients were also sub-grouped into diabetic and nondiabetic. Baseline characteristics were noted, and coronary angiogram and renal angiogram were also done. Based on variables, the chi-square test and t-test were employed to assess the significance. P-value < 0.05 was considered statistically significant.

Results

The mean age at presentation for patients with NSTEMI and hypertensive emergency was 58 years. Patients consuming alcohol were slightly higher (28, 28%) than those who smoked (23, 23%). Among all, 48 (48%) patients had diabetes. When considering the number of vessels, diabetic patients had more single-vessel diseases (18, 37.5%) and nondiabetic patients had more double-vessel diseases (15, 28.8%). The mean ejection fraction of the diabetic group was 56.1% ± 6.8% and the nondiabetic group was 54.2% ± 7.7%. Among all the patients, 52 (62.6%) used combination drugs, while 39 (46.9%) were on defaulter drugs.

Conclusions

Several risk factors like age, smoking, alcohol, and nonadherence to drugs were found to have an association with the occurrence of hypertensive emergency. Diabetes was found to be significantly associated with unfavorable coronary anatomy among the population.