Relationship between systolic blood pressure and renal function on clinical outcomes in patients with atrial fibrillation: a report from the prospective AF-GEN-UK Registry.
J Hypertens
; 2024 Aug 27.
Article
in En
| MEDLINE
| ID: mdl-39315543
ABSTRACT
BACKGROUND:
Blood pressure (BP) extremes and renal (dys)function contribute to poor outcomes in patients with atrial fibrillation (AF). Using data from the prospective AF-GEN-UK study, we investigated the effect of systolic BP and interaction with renal function for prognostication.METHODS:
Baseline systolic BP (SBP) values were recorded for 1580 patients (mean [SD] age 71 [11] years, 60% male) and categorized as follows 120-129âmmHg (nâ=â289, reference group) <110âmmHg (nâ=â165), 110-119âmmHg, (nâ=â254), 130-139âmmHg (nâ=â321), 140-159âmmHg (nâ=â385) and ≥160âmmHg (nâ=â166). Cox regression analysis, adjusted for age, oral anticoagulation (OAC) and CHA2DS2-VASc score established the impact of SBP, renal function and their interaction on 1-year outcomes. SBP groups were compared using ANOVA and chi-square tests.RESULTS:
OAC use was 84% and similar across SBP groups. Renal dysfunction [estimated baseline glomerular filtration rate (eGFR) < 60âml/min] was present in 24%, with significantly lower eGFR values in the SBP 110-119âmmHg group. History of heart failure was significantly higher in those with SBP <110âmmHg. SBP <110âmmHg was predictive of all cause-death on univariate [hazard ratio (HR) 2.36, 95% confidence interval (CI) 1.20-4.64] and adjusted (aHR 9.71, 95% CI 1.73-54.5) regression. There was no statistically significant interaction between SBP and eGFR, no associations of SBP with haemorrhagic or thromboembolic events.CONCLUSIONS:
In people with AF, SBP <110âmmHg was independently predictive of all-cause death, with no significant interaction between SBP and renal (dys)function. This may reflect general poor health and/or excessive antihypertensive therapy, which should be avoided.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
J Hypertens
Year:
2024
Document type:
Article