Hypertension-Associated AF Risk Higher in Older People, Women

By Anne Harding

NEW YORK (Reuters Health) - Suspected atrial fibrillation (AF) is common among hypertensive patients over 50, especially women and those 75 and older, according to a new study.

"According to our study, age and sex were independent predictors of suspected AF, with age over 75 years old being more significantly associated than sex. Therefore, we could suggest that elderly patients should follow European Society of Cardiology (ESC) recommendations and undergo opportunistic screening for AF," Dr. Paraskevi Savvari of Pfizer Hellas in Athens, Greece, the study's first author, told Reuters Health in an email.

The study was funded by Pfizer, which makes the AF medication dofetilide (Tikosyn).

Arterial hypertension (AH), which in itself increases the risk of ischemic and hemorrhagic stroke, is also associated with AF, an independent risk factor for thromboembolic stroke, Dr. Savvari and colleagues note in the Journal of Hypertension, online November 7.

The authors investigated the incidence of new AF in more than 2,400 patients with hypertension aged 50 and older. Home blood pressure (BP) monitoring identified suspected AF in 12.5%.

The suspected-AF group had a significantly higher average CHA2DS2-VASc score than those without suspected AF (3.3 vs. 2.8). Patients 75 and older had more than twice the odds of having suspected AF (P=0.001) than those under 64, while women had 34% higher odds than men (P=0.02).

There was also a trend toward increased AF risk in patients with chronic heart failure.

"Our results underscore the role of hypertension-associated AF as a contributor to increased thromboembolic risk and revise the need of asymptomatic AF detection devices in the clinical practice," Dr. Savvari said. "It should be however emphasized that these devices can only suggest the patients that need further investigation regarding occult AF through a 24h or more extended ECG."

This month, Pfizer and Bristol-Myers Squibb launched a randomized controlled trial, GUARD-AF, to determine if screening patients 70 and older for AF reduces stroke risk.

SOURCE: https://bit.ly/2Oplkyd

J Hypertens 2019.

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