It is of pre-eminent importance for the managing clinician to stratify the risk of myocardial infarction patients with respect to future cardiovascular morbidity and, in particular, cardiovascular mortality. The size of a myocardial infarction, the ejection fraction, the degree of myocardial revascularization and the status of the autonomic nervous system (and related arrthythmogenicity) are all established predictors that enable assessment of the individual risk of such patients. Likewise, modifiable risk factors predict future events and there is no doubt that treatment of hyperlipidaemia, stringent glycaemic control in diabetics and abstinence from smoking lead to a reduction in cardiovascular morbidity and mortality [1, 2]. Moreover, the prevalence of arterial hypertension is high in myocardial infarction patients compared to the normal population [3]. Therefore, the need for blood pressure lowering by medication is inferred as a measure of secondary prevention in patients with hypertensive [4] or even pre-hypertensive blood pressure levels [5]. Therefore, as reported in this issue of the journal, at first glance, it appears to be paradoxical that Yap et al.[6] correlate high blood pressure values during the phase of hospitalization for myocardial infarction with a decreased medium to long-term cardiovascular mortality.

The authors carried out a retrospective analysis on more than 3000 placebo-treated patients of the EMIAT, CAMIAT, SWORD, TRACE and DIAMOND–MI studies with ejection fractions< 40% or documented asymptomatic ventricular arrhythmias [6]. The data suggest that higher systolic and diastolic blood pressure values during hospitalization after myocardial infarction are associated with a decreased all-cause mortality and a raised rhythmogenic mortality. The investigation is interesting with respect to the idea of testing whether a vital parameter measured routinely during the hospitalization stay is predictive for the prognosis. Although such an investigation may be obvious, it was conducted systema-