Blood Pressure and Atrial Fibrillation: A Combined AF-CHF and AFFIRM Analysis

Journal of Cardiovascular Electrophysiology
Maxime Tremblay-GravelPaul Khairy

Abstract

Hypertension is an established risk factor for new-onset atrial fibrillation (AF). However, the relationship between blood pressure and recurrent AF is less well understood. A pooled analysis of patient-level data from AFFIRM and AF-CHF trials was conducted on all 2,715 patients with paroxysmal or persistent AF, 68 ± 8 years, 66% male, randomized to rhythm control and followed for 40.6 ± 16.5 months. We assessed the impact of a baseline systolic blood pressure (SBP; <120 mmHg [N = 1,008], 120-140 mmHg [N = 930], >140 mmHg [N = 777]) on recurrent AF and proportion of time spent in AF. In patients with LVEF >40% (N = 1,719), SBP was not associated with recurrent AF in multivariate regression analyses (P = 0.752). In contrast, in patients with LVEF ≤40% (N = 996), the AF recurrence rate was higher in those with an SBP >140 mmHg compared to 120-140 mmHg (hazard ratio 1.47; 95% CI [1.12-1.93], P = 0.005). The rate of recurrent AF was similar in patients with SBP <120 mmHg compared to 120-140 mmHg (hazard ratio 1.15; 95% CI [0.92-1.43], P = 0.225). Consistently, the proportion of time spent in AF was not influenced by SBP in patients with LVEF >40% (P = 0.645). However, in patients with LVEF ≤40%, the adjusted mean proportion of time...Continue Reading

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Citations

Jul 18, 2015·Progress in Cardiovascular Diseases·Arthur R MenezesFreddy M Abi-Samra
Apr 22, 2015·Current Hypertension Reports·Carmine SavoiaMassimo Volpe
Oct 11, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Hugh CalkinsUNKNOWN Document Reviewers:
Jul 26, 2019·Current Treatment Options in Cardiovascular Medicine·Neel J PatelPrashant D Bhave
Apr 8, 2017·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Joanna DietzelMatthias Endres
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Jun 21, 2021·European Journal of Clinical Investigation·Rosa AbellanaMiguel Angel Muñoz

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