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Review Article

IJMDC. 2024; 8(1): 333-339

Myocardial injury and myocardial infarction in hypertensive emergency patients; systematic review

Abdulrahman Khalid Alyemni, Abdulelah Mohammed A Altowairqi, Anwar Hamidi Alonizi, Malek Marwan Farhan, Mariya Riyad Alshaqi, Sarah Saad Mohammed Aseeri.


This systematic review aimed to determine the prevalence of myocardial injury, myocardial infarction (MI), and its subtypes in individuals presenting with hypertensive emergency. To find all pertinent published articles from 2017 to 2023 that reported studies on the prevalence of hypertensive emergencies and hypertension-mediated organ damage from inception to the date of database search were included. A systematic search of the Web of Science, PubMed, and MEDLINE databases was conducted. Finally eight articles were selected for the review. The authors collaborated using Google Sheets and Google Documents. Of the selected studies, three were retrospective, two were cross sectional, and three were prospective. In men admitted for hypertensive crises, psychomotor agitation and the burden of cardiovascular risk were much higher. Around one-third of patients experiencing hypertensive crises had elevated cardiac troponin, which can be used to identify individuals who are at a greater risk of death early and to provide important prognostic information. A lower BMI was associated with lower initial and serial troponin levels; this obesity paradox was especially prominent in older and female individuals. Three main factors that contributed to hypertensive emergencies (HE) and urgencies (HU) were stress, excessive salt consumption, and non-compliance. Renin-angiotensin system blockers seemed to be the cornerstone of therapy. The case fatality rate for patients undergoing hypertensive episodes was quite significant.

Key words: Myocardial Infarction, hypertensive emergency, myocardial injury, hypertensive urgencies, systemic review.

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