Ideal Blood Pressure in Patients With Atrial Fibrillation

The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for High Blood Pressure in Adults redefined hypertension as systolic blood pressure (BP) ≥130 mm Hg or diastolic BP ≥80 mm Hg. The optimal BP for patients with atrial fibrillation (AF) is uncertain. The goal of th...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 2018-09, Vol.72 (11), p.1233-1245
Main Authors: Kim, Daehoon, Yang, Pil-Sung, Kim, Tae-Hoon, Jang, Eunsun, Shin, Hyejung, Kim, Ha Yan, Yu, Hee Tae, Uhm, Jae-Sun, Kim, Jong-Youn, Pak, Hui-Nam, Lee, Moon-Hyoung, Joung, Boyoung, Lip, Gregory Y.H.
Format: Article
Language:English
Subjects:
Adults
Age
Aged
Anticoagulants
Asian Continental Ancestry Group
atrial fibrillation
Atrial Fibrillation - epidemiology
Blood Pressure
Cardiac arrhythmia
Cardiology
Cardiovascular disease
Cardiovascular diseases
cardiovascular outcome
Cerebral Hemorrhage - epidemiology
Confidence intervals
Data processing
Databases, Factual
Disease prevention
Diuretics
Female
Fibrillation
guideline
Health insurance
Health risk assessment
Health risks
Heart
Heart attacks
Heart diseases
Heart failure
Heart Failure - epidemiology
Hemorrhage
Humans
Hypertension
Hypertension - diagnosis
Hypertension - epidemiology
Ischemia
Male
Patients
Population
Practice Guidelines as Topic
Prevalence
Republic of Korea - epidemiology
Risk factors
Stroke
Stroke - epidemiology
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Summary:The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for High Blood Pressure in Adults redefined hypertension as systolic blood pressure (BP) ≥130 mm Hg or diastolic BP ≥80 mm Hg. The optimal BP for patients with atrial fibrillation (AF) is uncertain. The goal of this study was to investigate the impacts of the 2017 ACC/AHA guideline and to determine the ideal BP threshold for the management of high BP in patients with AF. This study analyzed data for 298,374 Korean adults with oral anticoagulant–naive, nonvalvular AF obtained from the National Health Insurance Service database from 2005 to 2015. According to the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure guideline, 62.2% of the individuals in our sample had hypertension. After applying the 2017 ACC/AHA guideline, 79.4% had hypertension, including 17.2% with newly redefined hypertension (130 to 139/80 to 89 mm Hg). Those with newly redefined hypertension had greater risks of major cardiovascular events (hazard ratio: 1.07; 95% confidence interval: 1.04 to 1.10; p < 0.001), ischemic stroke, intracranial hemorrhage, and heart failure admission, compared with nonhypertensive patients (
ISSN:0735-1097
1558-3597
DOI:10.1016/j.jacc.2018.05.076