Optimal blood pressure in patients with atrial fibrillation (from the AFFIRM Trial).
Publication/Presentation Date
9-1-2014
Abstract
Many medications used to treat atrial fibrillation (AF) also reduce blood pressure (BP). The relation between BP and mortality is unclear in patients with AF. We performed a post hoc analysis of 3,947 participants from the Atrial Fibrillation Follow-Up Investigation of Rhythm Management trial. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) at baseline and follow-up were categorized by 10-mm Hg increments. The end points were all-cause mortality (ACM) and secondary outcome (combination of ACM, ventricular tachycardia and/or fibrillation, pulseless electrical activity, significant bradycardia, stroke, major bleeding, myocardial infarction, and pulmonary embolism). SBP and DBP followed a "U-shaped" curve with respect to primary and secondary outcomes after multivariate analysis. A nonlinear Cox proportional hazards model showed that the incidence of ACM was lowest at 140/78 mm Hg. Subgroup analyses revealed similar U-shaped curves. There was an increased ACM observed with BP <110/60 mm Hg (hazard ratio 2.4, p
Volume
114
Issue
5
First Page
727
Last Page
736
ISSN
1879-1913
Published In/Presented At
Badheka, A. O., Patel, N. J., Grover, P. M., Shah, N., Patel, N., Singh, V., Deshmukh, A. J., Mehta, K., Chothani, A., Savani, G. T., Arora, S., Rathod, A., Marzouka, G. R., Lafferty, J., Mehta, J. L., & Mitrani, R. D. (2014). Optimal blood pressure in patients with atrial fibrillation (from the AFFIRM Trial). The American journal of cardiology, 114(5), 727–736. https://doi.org/10.1016/j.amjcard.2014.06.002
Disciplines
Medicine and Health Sciences
PubMedID
25060415
Department(s)
Fellows and Residents
Document Type
Article