Association of clinic and ambulatory blood pressure with new‐onset atrial fibrillation: A meta‐analysis of observational studies

Abstract

Various studies have shown that hypertension, 1,2 through different mechanisms, 3 is an important risk factor for incident atrial fibrillation (AF) which in turn increases cardiovascular risk. 4 Clinic blood pressure (BP) recording is traditionally used for diagnosis and management of hypertension. However, it has been largely reported that ambulatory BP is superior to clinic BP in predicting cardiovascular outcome. [5][6][7][8][9][10][11] In such a context, some studies have also evaluated whether ambulatory BP is superior to clinic BP in predicting new-onset AF. [12][13][14][15][16][17][18] It has been reported that daytime, [16][17][18] nighttime, [15][16][17][18] and 24-h BP [13][14][15][16][17][18] are independent predictors of new-onset AF and that these ambulatory BP measures tend to be superior to clinic BP [16][17][18] in predicting future AF. However, as there is still little information on this subject, 19 pooling all available evidence could allow for a more robust assessment of the association between AF and clinic and ambulatory BP.

Obstructive Sleep Apnea and Atrial Fibrillation

“…A recent meta-analysis showed that daytime, nighttime, and 24-h systolic blood pressure (BP) are similarly associated with future AF and that ambulatory systolic BP is a better predictor than clinic BP [ 69 ]. The mechanism involved in the effect of hypertension on AF is not well known but two main mechanisms are proposed.…”

Association between cardiovascular risk factors and atrial fibrillation

“…Several prospective cohort studies have shown that a strong risk factor for cardiovascular disease (CVD), including atrial fibrillation, is hypertension (29). Furthermore, in the study reported by Coccina F et al, both ambulatory and clinical systolic blood pressure prospectively predicted the onset of AF and daytime, nighttime, and 24-hour systolic blood pressure had similar correlations with future AF (42). Nevertheless, these studies covered a limited subgroup of population in general and were based on systolic blood pressure, potentially biasing the outcomes.…”

Atrial Fibrillation Detection and Management in Hypertension

“…It is noteworthy that a recent meta-analysis suggests that ambulatory (versus clinic) SBP predicts incident AF better and that daytime, night-time and 24-hour SBP are similarly associated with future AF. 45 Whether BP lowering guided by ambulatory BP measurements is stronger than BP lowering guided by clinic BP lowering in reducing new-onset AF requires further study.…”