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Systolic Blood Pressure and Effects of Screening for Atrial Fibrillation With Long-Term Continuous Monitoring (a LOOP
Lucas Yixi Xing1, Søren Zöga Diederichsen1,2, Søren Højberg2
1Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark (L.Y.X., S.Z.D., M.S.O., L.K., J.H.S.).
Hypertension (Dallas, Tex. : 1979)
|July 21, 2022
Summary
Systolic blood pressure influences atrial fibrillation screening effectiveness. Higher blood pressure amplified screening benefits for stroke prevention but also increased AF episode risk.
Area of Science:
- Cardiology
- Preventive Medicine
- Clinical Trials
Background:
- Hypertension is a known stroke and atrial fibrillation (AF) risk factor.
- Limited data exist on how systolic blood pressure (SBP) affects AF screening outcomes.
Purpose of the Study:
- To investigate the interaction between baseline SBP and the effectiveness of AF screening using implantable loop recorders (ILRs).
Main Methods:
- The LOOP Study randomized individuals aged 70-90 with stroke risk factors to ILR screening or usual care.
- This substudy analyzed 5997 participants with SBP data, assessing stroke or systemic arterial embolism risk using Cox models.
Main Results:
- ILR screening reduced stroke/embolism risk by 44% in participants with SBP ≥150 mmHg.
- Higher SBP (≥150 mmHg) correlated with increased long-duration AF episodes within the ILR group.
- The benefit of ILR screening for stroke prevention increased with higher SBP levels.
Conclusions:
- The impact of AF screening on thromboembolic events is modulated by blood pressure.
- Higher SBP amplifies AF screening's stroke risk reduction but also increases the risk of prolonged AF episodes.
- Further research is needed to confirm these hypothesis-generating findings.
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