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Elevated blood pressure may occur in patients with cardiac tamponade who have a history of hypertension. Cardiac tamponade is compression of blood returned to the heart from the body, and it is caused by fluid accumulation in the membrane surrounding the heart. Of 18 patients with cardiac tamponade, six had elevated blood pressure. All the patients with elevated blood pressure had a history of hypertension. In all six patients, blood pressure decreased significantly and cardiac output increased after the excess fluid was removed from the membrane surrounding the heart. Three of the patients with normal blood pressure had a history of hypertension. Removing fluid from the heart's membrane increased systolic blood pressure and increased cardiac output in these patients. Most patients with cardiac tamponade have normal or slightly lower blood pressure because the heart has a decreased capacity to pump blood.

Although mortality from cardiovascular diseases (CVDs) has been declining, it remains the leading cause of death among urban U.S. blacks. McCord and Freeman reported CVD as the major contributor to excess mortality in Central Harlem. However the disease-specific CVD mortality was not assessed. Thus, it was unclear what the distribution of specific CVDs was in Central Harlem and their contribution to excess mortality. We reviewed the vital statistics records of New York City (NYC) Department of Health for 1990 and identified all cases in which the cause of death was coded as cardiovascular (International Classification of Diseases-ICD, 9th Revision, codes 391, 393-398, 401-404, 410, 411, 414-417, 420-438 and 440-444). The total and disease-specific CVD mortality for NYC and Central Harlem were calculated using the appropriate 1990 census data as the denominator. Central Harlem residents aged between 25-64 years were at least twice as likely to die from cardiovascular causes, compared to NYC residents. Hypertension-related deaths, ICD codes 401 (essential hypertension), 402 (hypertensive heart disease), 403 (hypertensive renal disease), and 404 (hypertensive heart and renal disease), were the major cause of excess death for men and women in Central Harlem. These findings show the importance of hypertension as the main determinant of the excess cardiovascular mortality in urban blacks and suggest an increased risk of cardiovascular death in blacks residing in Central Harlem.