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

Autoři: Finlay A. McAlister aff001;  Rajibul Mian aff002;  Jonas Oldgren aff003;  Lars Wallentin aff003;  Michael Ezekowitz aff004;  Salim Yusuf aff002;  Stuart J. Connolly aff002;  Jeff S. Healey aff002
Působiště autorů: Division of General Internal Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada aff001;  Population Health Research Institute, McMaster University, Hamilton, Canada aff002;  Uppsala Clinical Research Center and Department of Medical Sciences, Uppsala University, Uppsala, Sweden aff003;  Lankenau Institute for Medical Research, Wynnewood, PA, United States of America aff004
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0226259



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.


We examined data from the RE-LY AF registry conducted at 164 emergency departments (EDs) in 47 countries between December 2007 and October 2011.


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 CHADS2 scores of 1 and 45.6% of those with NVAF and CHADS2 scores of 2 or more (46.9% and 45.3% for CHA2DS2-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%).


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.

Klíčová slova:

Atrial fibrillation – Blood pressure – Cardiovascular diseases – Critical care and emergency medicine – Diabetes mellitus – Hypertension – Medical risk factors – Physicians


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2020 Číslo 1