Clinical Electrophysiology -> Atrial Fibrillation & Atrial Flutter: -> Pharmacology (Antiarrhythmic drugs and anticoagulants) D-PO02 - Poster Session II (ID 47) Poster

D-PO02-225 - Clinical Implication Of Controlled Blood Pressure Level On Risk Of Thromboembolic Event In Patients With Nonvalvular Atrial Fibrillation (ID 264)

Disclosure
 M. Kim: Nothing relevant to disclose.

Abstract

Background: Hypertension is common comorbidity and risk factor for stroke in patients with atrial fibrillation (AF).
Objective: We aim to find the proper target of blood pressure (BP) for patients with nonvalvular AF and hypertension.
Methods: A 12,453 consecutive patients with hypertension and nonvalvular AF were enrolled between 2006 and 2017. Mean BP measurement at out-patient clinic was calculated with linear interpolation. Primary outcome was ischemic stroke and systemic embolism.
Results: Among 12,453 patients, mean systolic BP was over 140mmHg in 1,352 patients, between 120 to 140mmHg in 6,641 patients, and under 120mmHg in 4,460 patients. The mean age was 67.3±11.2 years, mean follow up duration was 949.0±1001.4 days, and mean BP measurement interval was 49.4±55.3 days. Event rate per year for ischemic stroke and systemic embolism was higher with the increased systolic BP (2.5% for <120mmHg group, 3.0% for 120-140mmHg group, and 3.3% for ≥140mmHg group). Compared with systolic BP 120-140mmHg group, systolic BP<120mmHg group showed significantly lower risk of ischemic stroke and systemic embolism (hazard ratio [HR] 0.83, 95% confidence interval [CI] 0.72-0.96, p-value = 0.01), and systolic BP≥140mmHg group showed no significant difference in risk of ischemic stroke and systemic embolism (HR 1.09, 95% CI 0.88-1.35, p-value=0.43). There was no significant difference on risk of ischemic stroke and systemic embolism regarding the diastolic BP.
Conclusion: Control of systolic BP to under the 120 mmHg showed lower risk of ischemic stroke and systemic embolism in patients with hypertension and nonvalvular AF. Degree of diastolic BP control did not show a significant difference.
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