Average Systolic Blood Pressure and Clinical Outcomes in Patients with Atrial Fibrillation: Prospective Data from COOL-AF Registry

Objective: To evaluate the results of treatment achieved blood pressure goal (BP goal) and results of hypertensive patient management. Subjects and methods: A study of 400 hypertensive patient intervention, treatment and management after 2 year. To assess the results of BP target, monitor the use of medicines, the situation of hospitalization and complications of stroke. Results: Treatment: -100% of patients using diuretics and angiotensin-converting enzyme inhibitors (ACEIs), 33% of patients using angiotensin receptor blockers (ARBs), 46.25% of patients using calcium channel blockers (CCBs) and 19.5% of patients using beta-blocker. After 24 months of treatment: 50.5% of patients using 1 antihypertensive drug, 22% of patients using 2 drugs, 20.5% of patients using 3 drugs and 7% of patients taking more than 3 drugs. After 24 months of treatment: 91.75% achieved BP target and 8.25% fail. -Average risk stratification: 97.32% achieved BP target, hight risk stratification: 95.91% and very hight risk stratification: 73.03%. After 24 months of treatment. -Stage 1: 88.48% achieved BP target, stage 2: 92.85% achieved BP target and stage 3: 71.08% achieved BP target. After 24 months of treatment. -Hypertesive results before treatment were: 159.80 ± 20,22mmHg average systolic blood pressure and 82.97 ± 5,82mmHg average diastolic blood pressure. After treatment: average systolic blood pressure 125.38 ± 6,88mmHg and average diastolic blood pressure 79.83 ± 1,79mmHg. No adverse change in the index of tests about lipidemia, liver, kidney, glucomia and no recorded cases of drug side effects. Management of patients: -There were 89% non-medical examinational patients 1 month, 5.25% non-medical examinational patients 2 months, 4.25% non-medical examinational patients 3 months and 1.5% non-medical examinational patients 4 months. There were 93.5% drop pill 1 month, 3.25% drop pill 2 months, 4.25% drop pill 3 months and no patient drop pill over 3 months. In 24 months follow-up, 47% hospitalized inpatients <5 times, 44.5% hospitalized inpatients 5-10 times, 3% hospitalized inpatients 11-15 times, 4.75% hospitalized inpatients from 16-20 times and 0.75% hospitalized inpatients > 20 times. -There were 32.75% hospitalized inpatients for reasons of hypertension and 63.75% hospitalized inpatients for other common diseases. -There were a total of 11592 contacts directly by phone for medical advice, medical reminders and examinational reminders during 24 months of management. -There were 0.5% of patients stroked during 24 months of treatment and management. Conclusion: Treatment by protocol and management by phone directly for medical taking and re-examinational reminders is the best resulted method of achieving blood pressure target and reducing complications of stroke for hypertensive patients. Key word: : blood pressure target; risk stratification; treatment; management; stage; phone.

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Faculty Opinions recommendation of Relative systolic blood pressure reduction and clinical outcomes in hyperacute intracerebral hemorrhage: the SAMURAI-ICH observational study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.725348970.793538776 ◽

2017 ◽

Author(s):

Lauren Sansing

Keyword(s):

Blood Pressure ◽

Observational Study ◽

Intracerebral Hemorrhage ◽

Systolic Blood Pressure ◽

Clinical Outcomes ◽

Blood Pressure Reduction ◽

Pressure Reduction

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Systolic blood pressure at admission and long‐term clinical outcomes in patients hospitalized for heart failure

ESC Heart Failure ◽

10.1002/ehf2.13521 ◽

2021 ◽

Author(s):

Xinghe Huang ◽

Jiamin Liu ◽

Shuang Hu ◽

Lihua Zhang ◽

Fengyu Miao ◽

...

Keyword(s):

Heart Failure ◽

Blood Pressure ◽

Systolic Blood Pressure ◽

Clinical Outcomes

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

European Journal of Preventive Cardiology ◽

10.1093/eurjpc/zwab061.225 ◽

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.

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

SSRN Electronic Journal ◽

10.2139/ssrn.4006241 ◽

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

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IMPACT OF ACHIEVED AVERAGE SYSTOLIC BLOOD PRESSURE LEVELS ON FUTURE MORTALITY AMONG A REAL-WORLD POPULATION OF PATIENTS WITH HYPERTENSION

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(20)32675-9 ◽

2020 ◽

Vol 75 (11) ◽

pp. 2048

Author(s):

J. Brent Muhlestein ◽

Benjamin Davies Horne ◽

Nathan A. Allred ◽

Erik R. Riessen ◽

Raymond McCubrey ◽

...

Keyword(s):

Blood Pressure ◽

Systolic Blood Pressure ◽

Real World ◽

World Population ◽

Average Systolic Blood Pressure

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

Journal of Clinical Hypertension ◽

10.1111/jch.13496 ◽

2019 ◽

Vol 21 (3) ◽

pp. 363-368 ◽

Cited By ~ 3

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

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Effects of Aging on the Variability of Arterial Pressure in Essential Hypertensive Patients

Clinical Science ◽

10.1042/cs063411s ◽

1982 ◽

Vol 63 (s8) ◽

pp. 411s-414s ◽

Cited By ~ 2

Author(s):

Jun Ogawa ◽

Shigeo Takata ◽

Gakuji Nomura ◽

Shiro Arai ◽

Takayuki Ikeda ◽

...

Keyword(s):

Blood Pressure ◽

Stroke Volume ◽

Systolic Blood Pressure ◽

Diastolic Blood Pressure ◽

Pulse Pressure ◽

Baroreflex Sensitivity ◽

Peripheral Resistance ◽

Resistance Index ◽

Average Systolic Blood Pressure ◽

Effects Of Aging

1. We studied the effects of aging on the variability of blood pressure in mild to moderate essential hypertensive subjects. 2. Cardiac index was greater and total peripheral resistance index was less in patients under 40 years (by an average of 1.06 litres min−1 m−2 and 9.23 mmHg 1−1 min−1 m−2) than in those over 40 respectively (P < 0.001 for each). 3. Pulse pressure/stroke volume was less by an average of 0.345 mmHg/ml in patients under 40 years than that in those over 40 (P < 0.001). Pulse pressure/stroke volume was correlated with age (r = 0.621), average systolic blood pressure (r = 0.623) and inversely with baroreflex sensitivity (r = −0.494). 4. Baroreflex sensitivity was less by an average of 3.1 ms/mmHg in patients over 30 years than in those under 30 (P < 0.025). Baroreflex sensitivity was inversely correlated with age (r = −0.617) and average systolic blood pressure (r = −0.589). 5. Beat by beat variability of systolic blood pressure was correlated with age (r = 0.460), particularly when the data of those in their twenties were excluded (r = 0.618), and significantly with pulse pressure/stroke volume (r = 0.650), average systolic blood pressure (r = 0.618) and inversely with baroreflex sensitivity (r = −0.477). These relationships were not observed for diastolic blood pressure. 6. Maximum difference in systolic blood pressure in a day was correlated with pulse pressure/stroke volume (r = 0.482) and average systolic blood pressure (r = 0.648) but not with baroreflex sensitivity. These relationships were not observed for diastolic blood pressure. 7. Variability of systolic blood pressure in patients over 30 years gradually increased with age. In contrast, those of systolic and diastolic blood pressures in subjects in their twenties were relatively large. This might be related to factors other than aging, presumably those which underlie the hyperdynamic circulatory state.

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