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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Effect of hypertension on anticoagulated patients with atrial fibrillation
Gregory Y H Lip1, Lars Frison, Margaretha Grind
1Haemostasis Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK. g.y.h.lip@bham.ac.uk
European Heart Journal
|February 10, 2007
Summary
Hypertension significantly increases stroke and systemic embolic events (SEE) risk in atrial fibrillation (AF) patients. Event rates markedly rise at systolic blood pressure (SBP) levels of 140 mmHg or higher.
Area of Science:
- Cardiology
- Neurology
- Clinical Trials
Background:
- Atrial fibrillation (AF) increases stroke risk.
- Blood pressure (BP) is a key factor in cardiovascular events.
- Previous studies suggest a link between hypertension and stroke in AF patients.
Purpose of the Study:
- To investigate the relationship between blood pressure and stroke/systemic embolic events (SEE) in AF patients.
- To determine if hypertension influences event rates in the SPORTIF III and V trials.
- To explore differences in event rates related to the degree of hypertension.
Main Methods:
- Analysis of data from the Stroke Prevention using an ORal Thrombin Inhibitor in atrial Fibrillation (SPORTIF) III and V trials.
- Cross-sectional and longitudinal analysis of systolic blood pressure (SBP) and event rates.
- Stratification of patients into quartiles based on SBP levels.
Main Results:
- Stroke and SEE rates increased with higher SBP quartiles in AF patients.
- The hazard ratio for stroke/SEE in the top SBP quartile was 1.83 compared to the lowest.
- Event rates for stroke/SEE increased markedly at mean SBP > 140 mmHg.
- No significant relationship was found between bleeding events and BP quartiles.
Conclusions:
- Hypertension is a significant contributor to stroke and SEE in AF.
- Elevated SBP levels (≥ 140 mmHg) are associated with a marked increase in event rates.
- Differences in stroke rates between SPORTIF III and V may be linked to the proportion of hypertensive patients in each trial.
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