Impact of hypertension on the outcome of patients admitted with acute coronary syndrome

OBJECTIVE The role of hypertension and its impact on outcome in patients with acute coronary syndrome (ACS) is still debated. This study aimed to compare the outcomes of hypertensive and nonhypertensive ACS patients. METHODS Using data of ACS patients enrolled in the Acute Myocardial Infarction in Switzerland Plus Registry from 1997 to 2013, characteristics at presentation and outcomes in hospital and after 1 year were analyzed. Hypertension was defined as previously diagnosed and treated by a physician. The primary endpoint was mortality. Data were analyzed using multiple logistic regressions. RESULTS Among 41 771 ACS patients, 16 855 (40.4%) were without and 24 916 (59.6%) with preexisting hypertension. Patients with preexisting hypertension had a more favorable in-hospital outcome [odds ratio (OR) in-hospital mortality 0.82, 95% confidence interval (CI) 0.73-0.93; P = 0.022]. The independent predictors of in-hospital mortality for patients with preexisting hypertension were age, Killip class greater than 2, Charlson Comorbidity Index greater than 1, no pretreatment with statins and lower admission systemic blood pressure. Preexisting hypertension was not an independent predictor of 1-year mortality in the subgroup of patients (n = 7801) followed: OR 1.07, 95% CI 0.78-1.47; P = 0.68. Independent predictors of mortality 1 year after discharge for the 4796 patients with preexisting hypertension were age, male sex and comorbidities. Angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists and statins prescribed at discharge improved the outcomes. CONCLUSION Outcome of ACS patients with preexisting hypertension was associated with an improved in-hospital prognosis after adjustment for their higher baseline risk. However, this effect was not long-lasting and does not necessarily mean a causal relationship exists. Short-term and long-term management of patients with hypertension admitted with ACS could be further improved.

Downwelling solar irradiance, upwelling solar radiance, sky leaving radiance, and cloud cover observed during ARCHEMHAB study (on Maria S. Merian Leg MSM21/3) from 2012-07-26 to 2012-08-10

The need to obtain ocean color essential climate variables (OC-ECVs) using hyperspectral technology has gained increased interest in recent years. Assessing ocean color on a large scale in high latitude environments using satellite remote sensing is constrained by polar environmental conditions. Nevertheless, on a small scale we can assess ocean color using above-water and in-water remote sensing. Unfortunately, above-water remote sensing can only determine apparent optical properties leaving the sea surface and is susceptible to near surface environmental conditions for example sky and sunglint. Consequently, we have to rely on accurate in-water remote sensing as it can provide both synoptic inherent and apparent optical properties of seawater. We use normalized water leaving radiance LWN or the equivalent remote sensing reflectance RRS from 27 stations to compare the differences in above-water and in-water OC-ECVs. Analysis of above-water and in-water RRS spectra provided very good match-ups (R2 > 0.97, MSE<1.8*10**-7) for all stations. The unbiased percent differences (UPD) between above-water and in-water approaches were determined at common OC-ECVs spectral bands (410, 440, 490, 510 and 555) nm and the classic band ratio (490/555) nm. The spectral average UPD ranged (5 - 110) % and band ratio UPD ranged (0 - 12) %, the latter showing that the 5% uncertainty threshold for ocean color radiometric products is attainable. UPD analysis of these stations West of Greenland, Labrador Sea, Denmark Strait and West of Iceland also suggests that the differences observed are likely a result of environmental and instrumental perturbations.