TY - JOUR
T1 - Office, central and ambulatory blood pressure for predicting incident atrial fibrillation in older adults
AU - Matsumoto, Kenji
AU - Jin, Zhezhen
AU - Homma, Shunichi
AU - Elkind, Mitchell S.V.
AU - Schwartz, Joseph E.
AU - Rundek, Tatjana
AU - Mannina, Carlo
AU - Ito, Kazato
AU - Sacco, Ralph L.
AU - Di Tullio, Marco R.
N1 - Funding Information:
Source of funding: This work was supported by grants from the National Institute of Neurological Disorders and Stroke (grant R01 NS36286 to Dr Di Tullio and R37 NS29993 to Drs Sacco and Elkind).
Publisher Copyright:
© 2021 Lippincott Williams and Wilkins. All rights reserved.
PY - 2021/1
Y1 - 2021/1
N2 - Objectives: Recently, more sophisticated blood pressure (BP) measurements, such as central and ambulatory BP (ABP), have proven to be stronger predictors of future cardiovascular disease than conventional office BP. Their predictive value for atrial fibrillation development is not established. We investigated the prognostic impact for incident atrial fibrillation of office, central and ambulatory BP measurements in a predominantly older population-based cohort. Methods: Of 1004 participants in the Cardiovascular Abnormalities and Brain Lesions (CABL) study, 769 in sinus rhythm with no history of atrial fibrillation or stroke (mean age 70.5 years) underwent ABP and arterial wave reflection analysis for central BP determination. Fine and Gray's proportional subdistribution hazards models were used to assess the association of BP parameters with incident atrial fibrillation. Results: During 9.5 years, atrial fibrillation occurred in 83 participants. No office BP variable showed a significant association with incident atrial fibrillation. Central SBP and central pulse pressure were marginally associated with incident atrial fibrillation in multivariate analysis. Among ABP variables, 24-h SBP [adjusted hazard ratio per 10mmHg, 1.24; 95% confidence interval (CI) 1.07-1.44; P=0.004], daytime SBP (adjusted hazard ratio per 10mmHg, 1.21; 95% CI 1.04-1.40; P=0.011) and night-time SBP (adjusted hazard ratio per 10mmHg, 1.22; 95% CI 1.07-1.39; P=0.002) were significantly associated with incident atrial fibillation. Conclusion: In a predominantly older, stroke-free community-based cohort, ABP was a better independent predictor of incident atrial fibrillation than central BP, whereas office BP was inadequate for this purpose.
AB - Objectives: Recently, more sophisticated blood pressure (BP) measurements, such as central and ambulatory BP (ABP), have proven to be stronger predictors of future cardiovascular disease than conventional office BP. Their predictive value for atrial fibrillation development is not established. We investigated the prognostic impact for incident atrial fibrillation of office, central and ambulatory BP measurements in a predominantly older population-based cohort. Methods: Of 1004 participants in the Cardiovascular Abnormalities and Brain Lesions (CABL) study, 769 in sinus rhythm with no history of atrial fibrillation or stroke (mean age 70.5 years) underwent ABP and arterial wave reflection analysis for central BP determination. Fine and Gray's proportional subdistribution hazards models were used to assess the association of BP parameters with incident atrial fibrillation. Results: During 9.5 years, atrial fibrillation occurred in 83 participants. No office BP variable showed a significant association with incident atrial fibrillation. Central SBP and central pulse pressure were marginally associated with incident atrial fibrillation in multivariate analysis. Among ABP variables, 24-h SBP [adjusted hazard ratio per 10mmHg, 1.24; 95% confidence interval (CI) 1.07-1.44; P=0.004], daytime SBP (adjusted hazard ratio per 10mmHg, 1.21; 95% CI 1.04-1.40; P=0.011) and night-time SBP (adjusted hazard ratio per 10mmHg, 1.22; 95% CI 1.07-1.39; P=0.002) were significantly associated with incident atrial fibillation. Conclusion: In a predominantly older, stroke-free community-based cohort, ABP was a better independent predictor of incident atrial fibrillation than central BP, whereas office BP was inadequate for this purpose.
KW - Ambulatory blood pressure
KW - Atrial fibrillation
KW - Blood pressure
KW - Central blood pressure
KW - Hypertension
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U2 - 10.1097/HJH.0000000000002613
DO - 10.1097/HJH.0000000000002613
M3 - Article
C2 - 33031165
AN - SCOPUS:85096645421
VL - 39
SP - 46
EP - 52
JO - Journal of Hypertension
JF - Journal of Hypertension
SN - 0263-6352
IS - 1
ER -