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Ambulatory systolic BP may predict incident AF
In a population-based cohort, ambulatory systolic BP was a predictor of future atrial fibrillation, as was a high daytime systolic BP load.
The researchers hypothesized that ambulatory BP could be a modifiable risk factor for development of AF. They recorded daytime BP in 3,956 participants randomly recruited from five countries in Europe, of whom 70.2% had 24-hour ambulatory BP monitoring.
Daytime systolic BP load, defined as percentage of systolic BP readings greater than 135 mm Hg, was calculated for all participants.
The outcome of interest was AF incidence as assessed by ECGs performed at baseline and follow-up, and from medical records. Median follow-up was 14 years; total follow-up was 58,810 person-years.
During the study period, 143 participants had incident AF, Valérie Tikhonoff, MD, PhD, from the department of medicine at University of Padua, Italy, and colleagues wrote.
For each standard deviation increase in 24-hour systolic BP, there was a 27% increased risk for incident AF (P = .0056), whereas for each standard deviation increase in daytime systolic BP, there was a 22% increased risk (P = .023), and for each standard deviation increase in nighttime BP, there was a 20% increased risk (P = .029), according to the researchers.
For each standard deviation increase in conventional systolic BP, there was a trend toward an 18% increased risk for AF (P = .06), they wrote.
Participants were stratified into quartiles based on daytime systolic BP load. Compared with the middle two quartiles, the lowest quartile (load < 3%) had a 51% reduced risk for incident AF (P = .0038), whereas the highest quartile (load > 38%) had a 46% increased risk for incident AF (P = .0094), Tikhonoff and colleagues wrote.
“Our study findings might have important clinical implications in the management of AF, including the prevention of AF,” the researchers wrote. “Better stratification of subjects at risk for new-onset AF is a way of objectively informing treatment decisions and discreetly distributing medical care. Our observations suggest that [ambulatory] BP monitoring should become routine in the AF risk stratification of patients with hypertension.” – by Erik Swain
Disclosures: The authors report no relevant financial disclosures.