Controlled Level and Variability of Systolic Blood Pressure on the Risk of Thromboembolic Events in Atrial Fibrillation

2022 ◽  
Author(s):  
Minsoo Kim ◽  
Min Soo Cho ◽  
Gi-Byoung Nam ◽  
Ungjeong Do ◽  
Jun Kim ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Thromboembolic Events

scholarly journals Hypertensive response in exercise - a tool to predict stroke risk?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
TE Graca Rodrigues ◽  
N Cunha ◽  
P Silverio-Antonio ◽  
P Couto Pereira ◽  
B Valente Silva ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Exercise Test ◽  
Cardiovascular Events ◽  
Protective Factor ◽  
Independent Predictor ◽  
Stress Test ◽  
Coronary Syndrome

Abstract Funding Acknowledgements Type of funding sources: None. Introduction There is some evidence suggesting that exaggerated hypertensive response to exercise (HRE) may be associated with higher risk of future cardiovascular events, however the relationship between systolic blood pressure (SPB) during exercise test and stroke is not fully understood. Purpose To evaluate the ability to predict the risk of stroke in patients with HRE in exercise test. Methods Single-center retrospective study of consecutive patients submitted to exercise test from 2012 to 2015 with HRE to stress test. HRE was defined as a peak systolic blood pressure (PSBP) > 210 mmHg in men and > 190 mmHg in women, or a rise of the SBP of 60 mmHg in men or 50 mmHg in women or as a diastolic blood pressure > 90 mmHg or a rise of 10 mmHg. Patient’s demographics, baseline clinical characteristics, vital signs during the stress test and the occurrence of stroke during follow-up were analysed Results We included 458 patients with HRE (76% men, 57.5 ± 10.83 years). The most frequent comorbidities were hypertension (83%), dyslipidaemia (61%), previously known coronary disease (32%), diabetes (28%) and smoking (38%). Atrial fibrillation was present in 5.9% of patients. During a mean follow-up of 60 ± 2 months, the incidence of stroke was 2.1% (n = 8), all with ischemic origin. Considering the parameters analysed on exercise test, only PSBP demonstrated to be an independent predictor of stroke (HR 1.042, CI95% 1.002-1.084, p = 0.039,) with moderate ability to predict stroke (AUC 0.735, p = 0.0016) with a most discriminatory value of 203 mmHg (sensibility 56%, specify 67%). Regarding baseline characteristics, after age, sex and comorbidities adjustment, previously controlled hypertension was found to be an independent protective factor of stroke (OR 4.247, CI 95% 0.05-0.9, p = 0.036) and atrial fibrillation was an independent predictor of stroke occurrence (HR 8.1, CI95% 1.4-46.9, p = 0.018). Atrial fibrillation was also associated with hospitalization of cardiovascular cause and major cardiovascular events occurrence (mortality, coronary syndrome and stroke). Baseline SBP was associated with atrial fibrillation development (p = 0.008). Conclusion According to our results, PSBP during exercise test is an independent predictor of stroke occurrence and should be considered as a potencial additional tool to predict stroke occurrence, particularly in high risk patients. The identification of diagnosed hypertension as a protective factor of stroke may be explained by the cardioprotective effect of antihypertensive drugs.

scholarly journals Systolic blood pressure increases in patients with atrial fibrillation regaining sinus rhythm after electrical cardioversion

2019 ◽  
Vol 21 (3) ◽  
pp. 363-368 ◽  
Author(s):  
Joakim Olbers ◽  
Ellen Jacobson ◽  
Fredrik Viberg ◽  
Nils Witt ◽  
Petter Ljungman ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Sinus Rhythm ◽  
Systolic Blood Pressure ◽  
Electrical Cardioversion

scholarly journals Association of systolic blood pressure with atrial fibrillation among treated hypertensive patients

2020 ◽  
Vol 9 (4) ◽  
pp. 1752-1763
Author(s):  
Chaolei Chen ◽  
Lin Liu ◽  
Yuling Yu ◽  
Geng Shen ◽  
Jiayi Huang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Hypertensive Patients

scholarly journals Different Influence of Blood Pressure on New-Onset Atrial Fibrillation in Pre- and Postmenopausal Women

Hypertension ◽  
2021 ◽  
Author(s):  
Yun Gi Kim ◽  
Kyung-Do Han ◽  
Do Young Kim ◽  
Yun Young Choi ◽  
Ha Young Choi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Risk Factor ◽  
Systolic Blood Pressure ◽  
Postmenopausal Women ◽  
Premenopausal Women ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Onset Atrial Fibrillation ◽  
New Onset

The characteristics of hypertension in pre- and postmenopausal women are different. Hypertension is a known risk factor for new-onset atrial fibrillation (AF), but its interaction with the menopause state is not fully established. We investigated whether menopause influences the adverse impact of high blood pressure on new-onset AF using a nationwide population-based cohort in Korea. People who underwent both a national health check-up and national cancer screening program were included in this study. A total of 3 280 834 women were assessed with 23 781 070 person*year follow-up data. Menopause was observed in 1 439 161 women. The risk of new-onset AF and blood pressure showed a linear relationship in premenopausal women ( P <0.001 for both systolic and diastolic blood pressure). The risk of new-onset AF was increased by 58.8% if systolic blood pressure was ≥160 mm Hg compared with the reference group (100 mm Hg ≤ systolic blood pressure <110 mm Hg; hazard ratio=1.588 [95% CI, 1.383–1.823]) in premenopause group. However, no consistent correlation was observed between blood pressure and the risk of new-onset AF in postmenopausal women. The increased risk of new-onset AF attributable to elevated blood pressure was more pronounced in patients not taking antihypertension medications ( P for interaction <0.001). In conclusion, elevated blood pressure, especially systolic blood pressure, was a significant risk factor for new-onset AF in premenopausal women. Postmenopausal women showed a significantly attenuated association between blood pressure and the risk of new-onset AF. Elevated systolic blood pressure had a more profound impact on new-onset AF in women not taking medications for hypertension.

Abstract 15578: Adiposity, Systolic Blood Pressure, Smoking and Atrial Fibrillation: Analyses of 2.3 Million US Adults Attending Cardiovascular Screening

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Richard Bulbulia ◽  
Paul Sherliker ◽  
Rachel Clack ◽  
Alison Halliday ◽  
Richard Peto ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Positive Association ◽  
Prior History ◽  
Men And Women ◽  
Cardiovascular Screening ◽  
Family Medical History ◽  
Never Smokers ◽  
And Gender

Aims: Unlike other vascular conditions, and for reasons that are incompletely understood, the prevalence of atrial fibrillation (AF) is rising sharply. Analysis of a large healthy cohort which was screened for AF allows reliable assessment of its association with several classical vascular risk factors. Methods: Between 2009 and 2013, around 3 million US adults attended cardiovascular screening clinics and had an ECG to identify AF. Personal and family medical history, medication use, smoking and alcohol consumption were recorded via questionnaires, and height, weight and blood pressure were measured. Age and gender-specific incidence of AF and associations between body mass index (BMI), systolic blood pressure (SBP) and smoking were measured in 2,320,190 participants with no reported prior history of AF, stroke or CHD. Results: The median age was 65, and two-thirds were female. The overall incidence of AF was 0.36%, but it was over twice as common in males (0.59%) than in females (0.23%) and rose sharply with age, doubling in each decade in both men and women. A positive association was seen between adiposity and AF in men and women across all ages studied: approximately 50% increase per 5 unit rise in BMI. By contrast, AF was only weakly associated with SBP - 10% increase per 10mmHg rise in SBP among participants aged under 70 years, and flat or even inversely associated among those over 70 years. Smoking was not associated with AF in men or women at any age (Odds Ratio for current vs never smokers = 0.97 [95% CI 0.79-1.19]). Conclusion: A 10 unit increase in BMI (ie, going from an “ideal” weight to “obese”) doubled the risk of AF. However, blood pressure was less strongly associated with AF, and only in those under 70 years, suggesting some other mechanism behind the BMI - AF association. Current smoking was not associated with AF. Rising rates of obesity may be driving the observed increase in AF in the developed world.

scholarly journals Systolic blood pressure and mortality in patients with atrial fibrillation and heart failure: insights from the AFFIRM and AF-CHF studies

2014 ◽  
Vol 16 (11) ◽  
pp. 1168-1174 ◽  
Author(s):  
Maxime Tremblay-Gravel ◽  
Paul Khairy ◽  
Denis Roy ◽  
Hugues Leduc ◽  
D. George Wyse ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Systolic Blood Pressure
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