Key result
Morning home hypertension affects ~66% of elderly patients with non-valvular atrial fibrillation.
Why the study?
The study was conducted to evaluate blood pressure control, the prevalence of masked hypertension, and anticoagulant use in elderly patients with non-valvular atrial fibrillation.
Cohort (n=5,204)
Yes
In elderly patients with non-valvular atrial fibrillation, over half of those with well-controlled clinic blood pressure have uncontrolled morning home blood pressure, highlighting a significant prevalence of masked hypertension.
Masked morning hypertension is common in elderly NVAF despite clinic control; hypothesis-generating for home BP monitoring trials.
In the ANAFIE Registry home blood pressure subcohort, we evaluated 5204 patients aged ≥75 years with non-valvular atrial fibrillation (NVAF) to assess blood pressure (BP) control, prevalence of masked hypertension, and anticoagulant use. Mean clinic (C) and home (H) systolic/diastolic BP(SBP/DBP) was 128.5/71.3 and 127.7/72.6 mm Hg, respectively. Overall, 77.5% of patients had hypertension; of these, 27.7%, 13.4%, 23.4%, and 35.6% had well-controlled, white coat, masked, and sustained hypertension, respectively. Masked hypertension prevalence increased with diabetes, decreased renal function, age ≥80 years, current smoker status, and chronic obstructive pulmonary disease. By morning/evening average, 59.0% of patients had mean H-SBP ≥ 125 mm Hg; 48.9% had mean C-SBP ≥ 130 mm Hg. Early morning hypertension (morning H-SBP ≥ 125 mm Hg) was found in 65.9% of patients. Although 51.1% of patients had well-controlled C-SBP, 52.5% of these had uncontrolled morning H-SBP. In elderly NVAF patients, morning H-BP was poorly controlled, and masked uncontrolled morning hypertension remains significant.
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Kario et al. (2020) conducted a cohort in Non-valvular atrial fibrillation (NVAF) (n=5,204). Blood pressure control status (morning home blood pressure vs clinic blood pressure) was evaluated on Prevalence of uncontrolled early morning home systolic blood pressure (≥125 mm Hg). In elderly patients with non-valvular atrial fibrillation, 65.9% had uncontrolled morning home systolic blood pressure, and among those with well-controlled clinic blood pressure, 52.5% had masked uncontrolled morning hypertension.
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