4.3 Article

High prevalence of masked uncontrolled morning hypertension in elderly non-valvular atrial fibrillation patients: Home blood pressure substudy of the ANAFIE Registry

Journal

JOURNAL OF CLINICAL HYPERTENSION
Volume 23, Issue 1, Pages 73-82

Publisher

WILEY
DOI: 10.1111/jch.14095

Keywords

atrial fibrillation; clinical blood pressure; elderly; home blood pressure; hypertension

Funding

  1. Daiichi Sankyo Co.

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The study evaluated the blood pressure control in elderly patients with non-valvular atrial fibrillation, finding that morning home blood pressure was poorly controlled in these patients, and masked uncontrolled morning hypertension was still significant.
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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