The usefulness of 24-hour blood pressure monitoring for the patients with atrial fibrillation: based on the variability of blood pressure parameters

Abstract

Objective The aim of this study was to test whether ambulatory blood pressure monitoring (ABPM) in patients with atrial fibrillation is reliable as in patients with sinus rhythm. Method This study included 92 persistent atrial fibrillation patients (50% females; mean age 70.49 ± 11.56 years) and 92 matched sinus rhythm patients (46% females; mean age 69.23 ± 12.63 years). The participants were examined simultaneously with 24-hour ABPM and 24-hour Holter electrocardiography. The mean 24-hour (24-hour-), daytime (day-) and nighttime (night-) BP, types of BP curve, morning systolic BP (SBP) surge (MBPS), the SD of BP readings and the coefficient of variability (the SD/mean BP × 100%) were compared between atrial fibrillation and sinus rhythm patients. Results No differences of 24-hour-, day- and night-SBP levels were observed between two groups. Meanwhile, the 24-hour-SD, day-SD and night-SD, as well as the coefficient of variability for SBP were also similar between two groups. There was no significant difference in the number of MBPS between the two groups. On diastolic BP (DBP), the similar 24 hour and day levels, the 24-hour-SD, day-SD and night-SD as well as the coefficient of variability were also similar between two groups. But the nighttime DBP levels and the night-SD were higher in atrial fibrillation than in sinus rhythm. Conclusion ABPM provides data with similar SBP variability in patients with atrial fibrillation as in subject with normal cardiac rhythm. The ABPM on oscillometric method may be suitable for the atrial fibrillation patients, especially for the SBP evaluation.

High prevalence of masked uncontrolled morning hypertension in elderly non‐valvular atrial fibrillation patients: Home blood pressure substudy of the ANAFIE Registry

“…[16][17][18][19] Both domestic and international hypertension guidelines recommend blood pressure management based on measurements obtained outside the clinical setting, such as home blood pressure measurement or ambulatory blood pressure monitoring, which seem to be more closely related to organ damage and risk of cardiovascular events than blood pressure measurements obtained in the clinical setting. 11,[16][17][18][19][20][21][22][23][24][25][26] Moreover, patients with masked hypertension have been shown to have a greater risk of stroke compared with patients with controlled blood pressure, even when the blood pressure measured in the clinical setting appeared well controlled. [27][28][29][30][31] The HONEST and JHOP registry studies showed that early morning hypertension measured at home was a strong risk factor for stroke.…”