From the Research
Initial Pathological Process in Myocardial Infarction (MI) with a History of Hypertension
The initial pathological process in Myocardial Infarction (MI) with a history of hypertension involves several key factors, including:
- Mechanical stress on blood vessels due to high blood pressure, leading to endothelial dysfunction and the progression of atherosclerosis 1
- Overactivation of neurohormones, accelerated development of atherosclerotic plaque, and altered intramyocardial coronary circulation 2
- Hypertension-mediated cardiac and vascular damage, including left ventricular hypertrophy and dysfunction 2
Role of Hypertension in MI
Hypertension plays a significant role in the development of coronary artery disease and MI, with studies showing that:
- Blood pressure reduction is associated with a significant decrease in the risk of coronary events 2
- Patients with hypertension are more likely to have impaired epicardial reperfusion, mortality, reinfarction, and target vessel revascularization (TVR) after primary angioplasty 3
- Hypertension is independently associated with higher mortality, reinfarction, and TVR in STEMI patients undergoing primary angioplasty with drug-eluting stents (DES) or bare-metal stents (BMS) 3
Pathophysiological Mechanisms
The pathophysiological mechanisms underlying the link between hypertension and MI are complex and involve:
- Endothelial dysfunction, inflammation, and oxidative stress 1, 2
- Activation of the renin-angiotensin system, which contributes to the development of atherosclerosis and myocardial infarction 1
- Microvascular injury and cardiac repair, which are critical components of the pathological process in MI 4, 5