Blood pressure measures and electrocardiogram-defined myocardial infarction in an Iranian population: Tehran Lipid and Glucose study.

The purpose of this study was to describe blood pressure values in Iranian adults with electrocardiogram (ECG) evidence of a myocardial infarction (MI). High blood pressure is a risk factor, and an ECG can be diagnostic of coronary artery disease. In recent studies the role of pulse pressure in predicting coronary artery disease has been suggested to be more important than that of blood pressure. From among participants of the Tehran Lipid and Glucose study, data for 2479 men and 3060 women aged > or =30 years not currently using any antihypertensive medication were collected. The study used the mean of two separate blood pressure measurements for each individual. ECG findings of all subjects were coded according to Minnesota ECG coding criteria, and they were categorized into probable/possible MI or no MI. ECG evidence of probable or possible MI was found in 1.2% of subjects (1.8% in men vs. 0.8% in women, p<0.001). Prevalence of ECG-defined MI in hypertensive persons was two-fold higher than in normotensives. Adjusted for age, sex, and body mass index, mean diastolic blood pressure was significantly lower in cases with ECG-defined MI than in subjects without MI (p<0.03). There was a strong positive correlation between pulse pressure and systolic blood pressure in both hypertensive/normotensive and MI/no MI groups at the p<0.001 level. There was a weak inverse correlation between diastolic blood pressure and pulse pressure in hypertensive/normotensive/no MI groups (-0.32 and -0.14, both p<0.001). Diastolic blood pressure was not correlated with pulse pressure in cases with MI. Prevalence of ECG-defined MI in hypertensive cases was higher than in normotensives. Systolic blood pressure is a better predictor for pulse pressure than diastolic blood pressure in both normotensive and hypertensive populations with or without ECG-defined MI.