Risk of Atrial Fibrillation in Masked and White Coat Uncontrolled Hypertension

2020 ◽  
Author(s):  
Francesca Coccina ◽  
Anna M Pierdomenico ◽  
Matteo De Rosa ◽  
Lorenzo Belli ◽  
Melissa Foglietta ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Confidence Interval ◽  
Sinus Rhythm ◽  
Ambulatory Blood Pressure ◽  
White Coat ◽  
Uncontrolled Hypertension ◽  
Hypertensive Patients ◽  
New Onset

Abstract Background Risk of atrial fibrillation (AF) in masked and white coat uncontrolled hypertension (MUCH and WUCH, respectively) has not yet been investigated. We assessed the risk of new-onset AF in MUCH and WUCH detected by ambulatory blood pressure (BP) monitoring. Methods The occurrence of AF was evaluated in 2135 treated hypertensive patients aged >40 years, with baseline sinus rhythm, by electrocardiogram. Controlled hypertension (CH) was defined as clinic BP <140/90 mmHg and daytime BP, regardless of nighttime BP, <135/85 mmHg, MUCH as clinic BP <140/90 mmHg and daytime BP ≥135 and/or ≥85 mmHg, WUCH as clinic BP >140 and/or >90 mmHg and daytime BP <135/85 mmHg and sustained uncontrolled hypertension (SUCH) as clinic BP >140 and/or >90 mmHg and daytime BP >135 and/or >85 mmHg. Results MUCH was identified in 203 patients (9.5% of all the population, 29% of those with normal clinic BP) and WUCH in 503 patients (23.5% of all the population, 35% of those with high clinic BP). During the follow-up (mean 9.7 years), 116 cases of AF occurred. After adjustment for covariates, patients with MUCH (hazard ratio (HR) 2.02, 95% confidence interval (CI) 1.06-3.85) and SUCH (HR 1.83, 95% CI, 1.04-3.21) had higher risk of new-onset AF than those with CH, whereas those with WUCH (HR 1.12, 95% CI, 0.59-2.13) did not. Conclusions When compared to patients with CH, those with MUCH and SUCH are at higher risk (approximately doubled) of new-onset AF, whereas those with WUCH are not.

Sequential follow-up clinic and ambulatory blood pressure evaluation in a low risk population of white-coat hypertensive patients and in normotensives

2005 ◽  
Vol 10 (2) ◽  
pp. 57-64 ◽  
Author(s):  
Jorge J. Pol??nia ◽  
Guilherme M. Gama ◽  
Jos?? A. Silva ◽  
Cristina Amaral ◽  
Luis R. Martins ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Low Risk ◽  
White Coat ◽  
Risk Population ◽  
Hypertensive Patients

scholarly journals Ambulatory blood pressure and risk of new‐onset atrial fibrillation in treated hypertensive patients

2020 ◽  
Author(s):  
Francesca Coccina ◽  
Anna M. Pierdomenico ◽  
Umberto Ianni ◽  
Matteo De Rosa ◽  
Andrea De Luca ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Hypertensive Patients ◽  
Onset Atrial Fibrillation ◽  
New Onset

Changes in 24-h ambulatory blood pressure following restoration of sinus rhythm in patients with atrial fibrillation

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Joakim Olbers ◽  
Jan Östergren ◽  
Mårten Rosenqvist ◽  
Helga Skuladottir ◽  
Sofia Klavebäck ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Sinus Rhythm ◽  
Ambulatory Blood Pressure

scholarly journals Ambulatory Blood Pressure Control Pattern in Hypertensive Patients at Tikur Anbesa Specialized Hospital: A Cross Sectional Study

2021 ◽  
Author(s):  
MULUALEM ALEMAYEHU ◽  
Sintayehu Abebe ◽  
Dejuma Yadeta ◽  
Bekele Alemayehu
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Addis Ababa ◽  
Cross Sectional Study ◽  
Uncontrolled Hypertension ◽  
Sectional Study ◽  
Ethical Guidelines ◽  
Cross Sectional ◽  
Hypertensive Patients ◽  
Control Pattern

Abstract Background: Hypertension is the most common cardiovascular problem globally with a particularly increasing burden in developing countries like Ethiopia. Ambulatory blood pressure (ABPM) is superior to office blood pressure (OBP) measurement for diagnosing, prognosticating and following treatment efficacy for hypertension. There is no available data on ABPM control pattern in Ethiopians. This study will determine the ABPM control patterns in Ethiopian hypertensive patients on treatment. Material and Methods: This was a cross sectional study in hypertensive patients at Tikur Anbessa Specialized Hospitals outpatient departments carried out during January to May 2021. ABPM values of 244 consecutively sampled patients were analyzed. All patients had their BP monitored over 24 h with a Tonoport V (GE CS V6 71), and the data was interpreted using GE CardiosoftTM ABPM software in accordance with European Society of hypertension guidelines. Ethical clearance was given by Addis Ababa University Institutional Review Board and the study was conducted in compliance to standard ethical guidelines.Results: The study involved 244 adult hypertensive patients; mean age of the patients was 59.4years and, 54% were females. 58.6% of patients had controlled OBP, while only 45.1% had controlled ABPM. The mean OBP was 137 (19)/81 (10) mmHg and mean 24-hr ABP was 137 (16)/81 (10) mmHg; mean daytime BP was 136/79 ± 17/11 mmHg; mean night‑time BP, 138/84 ± 16/11 mmHg. Mean ABPM values were not significantly different between men and women. Comparison of ABPM values with OBP revealed high prevalence of the white coat effect (32%) and masked uncontrolled hypertension (46%). Presence of comorbidities particularly diabetes predicted poor ABPM control.Conclusion: More than half of patients had uncontrolled BP as per ABPM criteria and significant discrepancy exists between ABPM and OBP in assessing adequacy of BP control. Guiding management decisions using ABPM can improve BP control rates.

scholarly journals Ambulatory blood pressure and long-term risk for atrial fibrillation

Heart ◽  
2018 ◽  
Vol 104 (15) ◽  
pp. 1263-1270 ◽  
Author(s):  
Valérie Tikhonoff ◽  
Tatiana Kuznetsova ◽  
Lutgarde Thijs ◽  
Nicholas Cauwenberghs ◽  
Katarzyna Stolarz-Skrzypek ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Population Based ◽  
European Population ◽  
Night Time ◽  
Cox Models ◽  
Increased Risk ◽  
Daytime Blood Pressure

ObjectiveData on the contribution of ambulatory blood pressure (ABP) components to the risk of developing atrial fibrillation (AF) are limited. We prospectively tested the hypothesis that ABP may represent a potentially modifiable risk factor for the development of AF in a European population study.MethodsWe recorded daytime blood pressure (BP) in 3956 subjects randomly recruited from the general population in five European countries. Of these participants, 2776 (70.2%) underwent complete 24-hour ABP monitoring. Median follow-up was 14 years. We defined daytime systolic BP load as the percentage BP readings above 135 mm Hg. The incidence of AF was assessed from ECGs obtained at baseline and follow-up and from records held by general practitioners and/or hospitals.ResultsOverall, during 58 810 person-years of follow-up, 143 participants experienced new-onset AF. In adjusted Cox models, each SD increase in baseline 24 hours, daytime and night-time systolic BP was associated with a 27% (P=0.0056), 22% (P=0.023) and 20% (P=0.029) increase in the risk for incident AF, respectively. Conventional systolic BP was borderline associated with the risk of AF (18%; P=0.06). As compared with the average population risk, participants in the lower quartile of daytime systolic BP load (<3%) had a 51% (P=0.0038) lower hazard for incident AF, whereas in the upper quartile (>38%), the risk was 46% higher (P=0.0094).ConclusionsSystolic ABP is a significant predictor of incident AF in a population-based cohort. We also observed that participants with a daytime systolic BP load >38% had significantly increased risk of incident AF.

scholarly journals Suitability, Efficacy, and Safety of Vernakalant for New Onset Atrial Fibrillation in Critically Ill Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Alain Rudiger ◽  
Alexander Breitenstein ◽  
Mattia Arrigo ◽  
Sacha P. Salzberg ◽  
Dominique Bettex
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Sinus Rhythm ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Blood Pressure Monitoring ◽  
Exclusion Criteria ◽  
Arterial Blood ◽  
Onset Atrial Fibrillation ◽  
New Onset

Objectives. This study investigates the suitability, safety, and efficacy of vernakalant in critically ill patients with new onset atrial fibrillation (AF) after cardiac surgery.Methods. Patients were screened for inclusion and exclusion criteria according to the manufacturers’ recommendations. Included patients were treated with 3 mg/kg of vernakalant over 10 min and, if unsuccessful, a second dose of 2 mg/kg. Blood pressure was measured continuously for 2 hours after treatment.Results. Of the 191 patients screened, 159 (83%) were excluded, most importantly due to hemodynamic instability (59%). Vernakalant was administered to 32 (17% of the screened) patients. Within 6 hours, 17 (53%) patients converted to sinus rhythm. Blood pressure did not decrease significantly 10, 30, 60, and 120 minutes after the vernakalant infusion. However, 11 patients (34%) experienced a transient decrease in mean arterial blood pressure <60 mmHg. Other adverse events included nausea (n=1) and bradycardia (n=2).Conclusions. Applying the strict inclusion and exclusion criteria provided by the manufacturer, only a minority of postoperative ICU patients with new onset AF qualified for vernakalant. Half of the treated patients converted to sinus rhythm. The drug was well tolerated, but close heart rate and blood pressure monitoring remains recommended.

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