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Risk Factors Influencing Outcomes of Atrial Fibrillation in ALLHAT
L Julian Haywood1, Barry R Davis2, Linda B Piller2
1LAC+USC Medical Center, Keck School of Medicine, Los Angeles, CA, USA.
Journal of the National Medical Association
|August 22, 2018
Summary
Atrial fibrillation and atrial flutter (AF/AFL) significantly increase the risk of stroke, heart failure, and mortality in high-risk hypertensive patients. These additional risk factors remain consistent whether AF/AFL is present at baseline or develops during treatment.
Area of Science:
- Cardiology
- Clinical Trials
- Epidemiology
Background:
- The ALLHAT trial investigated treatments for high-risk hypertensive individuals.
- Post-hoc analyses examined atrial fibrillation/atrial flutter (AF/AFL) in relation to major cardiovascular outcomes.
Purpose of the Study:
- To determine the impact of baseline and incident AF/AFL on stroke, heart failure (HF), coronary heart disease (CHD), and mortality.
- To assess if risk factor profiles differ between participants with and without AF/AFL.
Main Methods:
- Utilized ECG data from the ALLHAT trial to identify baseline and incident AF/AFL cases.
- Employed Cox regression analysis to estimate hazard ratios for outcomes, adjusting for baseline characteristics.
Main Results:
- Baseline AF/AFL was significantly associated with increased risk of stroke, HF, and mortality.
- Incident AF/AFL was a significant risk factor for HF and mortality.
- Risk factor profiles were largely similar for participants with and without AF/AFL.
Conclusions:
- Atrial fibrillation/atrial flutter is a significant independent risk factor for major adverse cardiovascular events and mortality.
- Management strategies should consider AF/AFL as a critical risk indicator in hypertensive populations.
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