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 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 Synergistic Impact of Systolic Blood Pressure and Perfusion Status on Mortality in Acute Heart Failure

2021 ◽  
Vol 14 (3) ◽  
Author(s):  
Xavier Rossello ◽  
Héctor Bueno ◽  
Víctor Gil ◽  
Javier Jacob ◽  
Francisco Javier Martín-Sánchez ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Physical Examination ◽  
Systolic Blood Pressure ◽  
Acute Heart Failure ◽  
Positive Association ◽  
Prognostic Impact ◽  
Inverse Association ◽  
Logistic Regression Models ◽  
Short Term Mortality

Background: Physical examination remains the cornerstone in the assessment of acute heart failure. There is a lack of adequately powered studies assessing the combined impact of both systolic blood pressure (SBP) and hypoperfusion on short-term mortality. Methods: Patients with acute heart failure from 41 Spanish emergency departments were recruited consecutively in 3 time periods between 2011 and 2016. Logistic regression models were used to assess the association of 30-day mortality with SBP (<90, 90–109, 110–129, and ≥130 mm Hg) and with manifestations of hypoperfusion (cold skin, cutaneous pallor, delayed capillary refill, livedo reticularis, and mental confusion) at admission. Results: Among 10 979 patients, 1143 died within the first 30 days (10.2%). There was an inverse association between 30-day mortality and initial SBP (35.4%, 18.9%, 12.4%, and 7.5% for SBP<90, SBP 90–109, SBP 110–129, and SBP≥130 mm Hg, respectively; P <0.001) and a positive association with hypoperfusion (8.0%, 14.8%, and 27.6% for those with none, 1, ≥2 signs/symptoms of hypoperfusion, respectively; P <0.001). After adjustment for 11 risk factors, the prognostic impact of hypoperfusion on 30-day mortality varied across SBP categories: SBP≥130 mm Hg (odds ratio [OR]=1.03 [95% CI, 0.77–1.36] and OR=1.18 [95% CI, 0.86–1.62] for 1 and ≥2 compared with 0 manifestations of hypoperfusion), SBP 110 to 129 mm Hg (OR=1.23 [95% CI, 0.86–1.77] and OR=2.18 [95% CI, 1.44–3.31], respectively), SBP 90 to 109 mm Hg (OR=1.29 [95% CI, 0.79–2.10] and OR=2.24 [95% CI, 1.36–3.66], respectively), and SBP<90 mm Hg (OR=1.34 [95% CI, 0.45–4.01] and OR=3.22 [95% CI, 1.30–7.97], respectively); P -for-interaction =0.043. Conclusions: Hypoperfusion confers an incremental risk of 30-day all-cause mortality not only in patients with low SBP but also in normotensive patients. On admission, physical examination plays a major role in determining prognosis in patients with acute heart failure.

Sex and gender differences overview

ESC CardioMed ◽  
2018 ◽  
pp. 2827-2830
Author(s):  
Eva Prescott
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
Obstructive Coronary Artery Disease ◽  
Systolic Heart Failure ◽  
Sex And Gender ◽  
Men And Women ◽  
Artery Disease ◽  
And Gender ◽  
Sex And Gender Differences

There are well-described differences between men and women in epidemiology, pathophysiology, presentation, and outcome of heart disease. Although risk factors responsible for cardiovascular disease are similar in men and women their relative importance differs. Puzzlingly, women have more angina yet less obstructive coronary artery disease. Also, when they suffer myocardial infarction, women more often present with myocardial infarction with non-obstructed coronary arteries (MINOCA) and takotsubo cardiomyopathy. Women have less systolic heart failure than men but more heart failure with preserved ejection fraction, a condition yet to find evidence-based treatment. Atrial fibrillation is also less common in women than men of similar age, but women with atrial fibrillation have higher risk of stroke than their male counterparts.

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 Systolic Blood Pressure and Adiposity: Examination by Race and Gender in a Nationally Representative Sample of Young Adults

2012 ◽  
Vol 25 (2) ◽  
pp. 140-144 ◽  
Author(s):  
B. H. Brummett ◽  
M. B. Babyak ◽  
I. C. Siegler ◽  
R. Surwit ◽  
A. Georgiades ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Systolic Blood Pressure ◽  
Representative Sample ◽  
Race And Gender ◽  
Nationally Representative ◽  
And Gender

scholarly journals Handedness and gender influence blood pressure in young healthy men and women: A pilot study

2016 ◽  
Vol 50 (1) ◽  
pp. 10-15 ◽  
Author(s):  
I Rueda ◽  
I Banegas ◽  
I Prieto ◽  
R Wangensteen ◽  
AB Segarra ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sex Hormones ◽  
Sex Steroids ◽  
Menstrual Phase ◽  
Men And Women ◽  
Left Handed ◽  
Gender Influence ◽  
Left And Right ◽  
And Gender ◽  
The Right

AbstractObjective. The type and level of sex steroids influence blood pressure (BP). It has been suggested that functional brain asymmetries may be influenced by sex hormones. In addition, there are inter-arm differences in BP not yet related with handedness. In this study, we hypothesize a possible association between sex hormones, handedness, and inter-arm differences in blood pressure.Methods. To analyze this hypothesis, we measured BP in the left and right arm of the left and right handed adult young men and women in menstrual and ovulatory phase and calculated their mean arterial pressure (MAP).Results. Significant differences depending on sex, arm, handedness or phase of the cycle were observed. MAP was mostly higher in men than in women. Remarkably, in women, the highest levels were observed in the left handed in menstrual phase. Interestingly, the level of handedness correlated negatively with MAP measured in the left arm of right-handed women in the ovulatory phase but positively with the MAP measured in the right arm of right-handed women in the menstrual phase.Conclusions. These results may reflect an asymmetrical modulatory influence of sex hormones in BP control.

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