Hypertension is a major modifiable risk factor contributing to the development of Acute Coronary Syndrome (ACS), which includes STEMI, NSTEMI, and unstable angina. The increasing prevalence of hypertension worldwide raises concern regarding its impact on cardiovascular outcomes. This study aimed to describe the profile of ACS patients with hypertension receiving angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) therapy in the Intensive Coronary Care Unit (ICCU) of RSUD Dr. Soetomo Surabaya. Using a descriptive cross-sectional method, data from 91 patients treated between July 2021 and October 2024 were analyzed. Variables included demographic characteristics, clinical classification of ACS, hypertension degree, comorbidities, types and doses of ACEI/ARB administered. The results showed that most patients were male (73%) and aged over 65 years (40%). Chi-square analysis revealed no significant relationship between hypertension degree, ACS classification, or most comorbidities with drug selection or dosage (p>0.05), except for a significant association between coronary heart disease comorbidity and ARB selection. These findings suggest that in hypertensive ACS patients, the choice between ACEI and ARB therapy is predominantly based on individual comorbidity profiles rather than blood pressure severity or ACS type. The study highlights the importance of personalized treatment approaches considering patient comorbidities to optimize cardiovascular outcomes.
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