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Hypertension prevalence but not control varies across the spectrum of risk in patients with atrial fibrillation: A RE-LY atrial fibrillation registry sub-study

BACKGROUND: Although hypertension is the most common risk factor for atrial fibrillation (AF), whether blood pressure (BP) control varies across the spectrum of stroke risk in patients with AF or by adequacy of their thromboprophylaxis management is unclear. METHODS: We examined data from the RE-LY...

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Autores principales: McAlister, Finlay A., Mian, Rajibul, Oldgren, Jonas, Wallentin, Lars, Ezekowitz, Michael, Yusuf, Salim, Connolly, Stuart J., Healey, Jeff S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961825/
https://www.ncbi.nlm.nih.gov/pubmed/31940361
http://dx.doi.org/10.1371/journal.pone.0226259
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author McAlister, Finlay A.
Mian, Rajibul
Oldgren, Jonas
Wallentin, Lars
Ezekowitz, Michael
Yusuf, Salim
Connolly, Stuart J.
Healey, Jeff S.
author_facet McAlister, Finlay A.
Mian, Rajibul
Oldgren, Jonas
Wallentin, Lars
Ezekowitz, Michael
Yusuf, Salim
Connolly, Stuart J.
Healey, Jeff S.
author_sort McAlister, Finlay A.
collection PubMed
description BACKGROUND: Although hypertension is the most common risk factor for atrial fibrillation (AF), whether blood pressure (BP) control varies across the spectrum of stroke risk in patients with AF or by adequacy of their thromboprophylaxis management is unclear. METHODS: We examined data from the RE-LY AF registry conducted at 164 emergency departments (EDs) in 47 countries between December 2007 and October 2011. RESULTS: Of the 15,400 patients in the registry, we analyzed the 9929 (mean age 67.5 years, 51.9% men) with a prior history of AF and complete BP data. While 6508 (66.5%) AF patients had hypertension, the prevalence varied widely depending on comorbidity profiles: from 45.4% in those without other cardiovascular risk factors to 82.5% in those with AF and diabetes. Although 93.9% of AF patients with hypertension were on at least one antihypertensive agent, fewer than half had BP levels ≤ 140/90 with no difference across risk profiles: 45.9% of those with NVAF and CHADS(2) scores of 1 and 45.6% of those with NVAF and CHADS(2) scores of 2 or more (46.9% and 45.3% for CHA(2)DS(2)-VASc scores of 1 versus 2 or more). BP control rates were not significantly better in those NVAF patients receiving guideline concordant thromboprophylaxis management (47.2%, aOR 1.03, 95%CI 0.89–1.20) than in those not receiving guideline-concordant antithrombotic therapy (45.3%). CONCLUSIONS: Hypertension was common in patients with AF but BP control rates were sub-optimal and varied little across the spectrum of stroke risk or by adequacy of thromboprophylaxis. This highlights the need for an increased focus on total atherosclerotic risk rather than just thromboprophylaxis management in AF patients.
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spelling pubmed-69618252020-01-26 Hypertension prevalence but not control varies across the spectrum of risk in patients with atrial fibrillation: A RE-LY atrial fibrillation registry sub-study McAlister, Finlay A. Mian, Rajibul Oldgren, Jonas Wallentin, Lars Ezekowitz, Michael Yusuf, Salim Connolly, Stuart J. Healey, Jeff S. PLoS One Research Article BACKGROUND: Although hypertension is the most common risk factor for atrial fibrillation (AF), whether blood pressure (BP) control varies across the spectrum of stroke risk in patients with AF or by adequacy of their thromboprophylaxis management is unclear. METHODS: We examined data from the RE-LY AF registry conducted at 164 emergency departments (EDs) in 47 countries between December 2007 and October 2011. RESULTS: Of the 15,400 patients in the registry, we analyzed the 9929 (mean age 67.5 years, 51.9% men) with a prior history of AF and complete BP data. While 6508 (66.5%) AF patients had hypertension, the prevalence varied widely depending on comorbidity profiles: from 45.4% in those without other cardiovascular risk factors to 82.5% in those with AF and diabetes. Although 93.9% of AF patients with hypertension were on at least one antihypertensive agent, fewer than half had BP levels ≤ 140/90 with no difference across risk profiles: 45.9% of those with NVAF and CHADS(2) scores of 1 and 45.6% of those with NVAF and CHADS(2) scores of 2 or more (46.9% and 45.3% for CHA(2)DS(2)-VASc scores of 1 versus 2 or more). BP control rates were not significantly better in those NVAF patients receiving guideline concordant thromboprophylaxis management (47.2%, aOR 1.03, 95%CI 0.89–1.20) than in those not receiving guideline-concordant antithrombotic therapy (45.3%). CONCLUSIONS: Hypertension was common in patients with AF but BP control rates were sub-optimal and varied little across the spectrum of stroke risk or by adequacy of thromboprophylaxis. This highlights the need for an increased focus on total atherosclerotic risk rather than just thromboprophylaxis management in AF patients. Public Library of Science 2020-01-15 /pmc/articles/PMC6961825/ /pubmed/31940361 http://dx.doi.org/10.1371/journal.pone.0226259 Text en © 2020 McAlister et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
McAlister, Finlay A.
Mian, Rajibul
Oldgren, Jonas
Wallentin, Lars
Ezekowitz, Michael
Yusuf, Salim
Connolly, Stuart J.
Healey, Jeff S.
Hypertension prevalence but not control varies across the spectrum of risk in patients with atrial fibrillation: A RE-LY atrial fibrillation registry sub-study
title Hypertension prevalence but not control varies across the spectrum of risk in patients with atrial fibrillation: A RE-LY atrial fibrillation registry sub-study
title_full Hypertension prevalence but not control varies across the spectrum of risk in patients with atrial fibrillation: A RE-LY atrial fibrillation registry sub-study
title_fullStr Hypertension prevalence but not control varies across the spectrum of risk in patients with atrial fibrillation: A RE-LY atrial fibrillation registry sub-study
title_full_unstemmed Hypertension prevalence but not control varies across the spectrum of risk in patients with atrial fibrillation: A RE-LY atrial fibrillation registry sub-study
title_short Hypertension prevalence but not control varies across the spectrum of risk in patients with atrial fibrillation: A RE-LY atrial fibrillation registry sub-study
title_sort hypertension prevalence but not control varies across the spectrum of risk in patients with atrial fibrillation: a re-ly atrial fibrillation registry sub-study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961825/
https://www.ncbi.nlm.nih.gov/pubmed/31940361
http://dx.doi.org/10.1371/journal.pone.0226259
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