MEDICAL ALMIGHTY

-- It may be possible to predict who will survive or die as the result of a first heart attack, researchers have found.

They analyzed data from more than 18,000 people in two of the largest U.S. cardiovascular studies and pinpointed certain traits that could predict the risk that a heart attack would be fatal. Those traits included having high blood pressure, being black and having a very high body mass index (BMI) -- a measurement based on height and weight.

"For some people, the first heart attack is more likely to be their last," lead author Dr. Elsayed Z. Soliman, director of the Epidemiological Cardiology Research Center (EPICARE) at Wake Forest Baptist Medical Center, said in a center news release. "For these people especially, it is important that we find ways to prevent that first heart attack from ever happening because their chances of living through it are not as good."

Among the researchers' findings:

The study was released online July 20 in advance of publication in an upcoming print issue of the journal Heart.

If the findings are validated and confirmed in future research, doctors will be able to identify patients who are at greater risk of dying if they suffer a heart attack and prescribe ways to reduce their risk, Soliman said.

pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "pre-hypertension", and a blood pressure of 140/90 or above is considered high.

The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed.

An elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart (cardiac) disease, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke(brain damage). These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure. For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.

It was previously thought that rises in diastolic blood pressure were a more important risk factor than systolic elevations, but it is now known that in people 50 years or older systolic hypertension represents a greater risk.

The American Heart Association estimates high blood pressure affects approximately one in three adults in the United States - 73 million people. High blood pressure is also estimated to affect about two million Americanteens and children, and the Journal of the American Medical Association reports that many are under-diagnosed. Hypertension is clearly a major public health problem.