Blood pressure control in anticoagulated patients with hypertension and atrial fibrillation

OBJECTIVE: To determine the clinical profile and blood pressure (BP) control rates of anticoagulated patients with hypertension and atrial fibrillation (AF). METHODS: The PAULA study was a multicenter cross-sectional/retrospective observational study conducted throughout Spain. The study included patients with nonvalvular AF who were receiving vitamin K antagonist therapy during the past year and were attended at primary care setting. Adequate BP control was defined according to 2013 ESC/ESH guidelines. RESULTS: -VASc 4.2 ± 1.4; HAS-BLED 1.6 ± 0.9). 33.5% of patients had diabetes, 24.9% heart failure and 14.0% prior stroke/transient ischemic attack. Mean BP was 131.4 ± 14.5/74.9 ± 9.8 mm Hg. With regard to antihypertensive treatment, most of patients were on combined therapy (67.9%). The commonest prescribed antihypertensive drugs were diuretics (64.4%), followed by angiotensin receptor blockers (30.1%), and beta blockers (29.4%). 75.2% of hypertensive patients achieved BP control targets; 86.6% of patients ≥80 years and 67.6% of diabetics. CONCLUSIONS: More than 75% of hypertensive patients with AF achieved BP goals, and this rate was higher in elderly. More than 2 thirds of patients were on combined therapy. BP control appears to be better in AF patients than in general hypertensive population.