Risk of Atrial Fibrillation in Masked and White Coat Uncontrolled Hypertension. (13th November 2020)

• Record Type: Journal Article
• Authors: Coccina, Francesca; Pierdomenico, Anna M; De Rosa, Matteo; Lorenzo, Belli; Foglietta, Melissa; Petrilli, Ivan; Vitulli, Piergiusto; Pizzicannella, Jacopo; Trubiani, Oriana; Cipollone, Francesco; Renda, Giulia; Pierdomenico, Sante D
• Is Part Of: American journal of hypertension. Volume 34:Number 5(2021)
• Page Start: 504
• Page End: 510
• Publication Date: 2020-11-13
• Subjects: atrial fibrillation -- blood pressure -- hypertension -- masked hypertension -- white coat hypertension; Hypertension -- Periodicals; 616.132005
• DOI: 10.1093/ajh/hpaa185
• Languages: English
• ISSNs: 0895-7061

Abstract

Abstract: BACKGROUND: Risk of atrial fibrillation (AF) in masked and white coat uncontrolled hypertension (MUCH and WUCH, respectively) has not yet been investigated. We assessed the risk of new-onset AF in MUCH and WUCH detected by ambulatory blood pressure (BP) monitoring. METHODS: The occurrence of AF was evaluated in 2, 135 treated hypertensive patients aged >40 years, with baseline sinus rhythm, by electrocardiogram. Controlled hypertension (CH) was defined as clinic BP <140/90 mm Hg and daytime BP, regardless of nighttime BP, <135/85 mm Hg, MUCH as clinic BP <140/90 mm Hg and daytime BP ≥135 and/or ≥85 mm Hg, WUCH as clinic BP ≥140 and/or ≥90 mm Hg and daytime BP <135/85 mm Hg, and sustained uncontrolled hypertension (SUCH) as clinic BP ≥140 and/or ≥90 mm Hg and daytime BP ≥135 and/or ≥85 mm Hg. RESULTS: MUCH was identified in 203 patients (9.5% of all the population, 29% of those with normal clinic BP) and WUCH in 503 patients (23.5% of all the population, 35% of those with high clinic BP). During the follow-up (mean 9.7 years), 116 cases of AF occurred. After adjustment for covariates, patients with MUCH (hazard ratio 2.02, 95% confidence interval, 1.06–3.85) and SUCH (hazard ratio 1.83, 95% confidence interval, 1.04–3.21) had higher risk of new-onset AF than those with CH, whereas those with WUCH (hazard ratio 1.12, 95% confidence interval, 0.59–2.13) did not. CONCLUSIONS: When compared with patients with CH, those with MUCH and SUCH are at higher risk (approximately doubled) of new-onset AF, whereas those with WUCH are not. Graphical Abstract: