［2022/10/5] From the J-RHYTHM registry, systolic blood pressure time in target range (BP-TTR: 110-130 mmHg) and time within <110 mmHg are useful in assessing the risk of cardiovascular death and thromboembolism in patients with nonvalvular atrial fibrillation, according to a report in the October 1 issue of the American Journal of Cardiology by Dr. Eitaro Kodani and his colleagues at the Nippon Medical School Tama Nagayama Hospital.
Effect of TTR of systolic blood pressure on adverse events in patients with non-valvular atrial fibrillation: the J-RHYTHM registry
Dr.Kodani and colleagues conducted a post-hoc analysis of 7,226 outpatients (mean age 70 years, 71% male) with non-valvular atrial fibrillation enrolled in the J-RHYTHM registry who had at least 4 (15 ± 5) BP measurements during the 2-year follow-up period or before the event. They examined the impact of BP-TTR on adverse events. Systolic BP TTR was calculated by Rosendaal linear interpolation with a target range of 110-130 mmHg.
Overall systolic BP-TTR averaged 50%. Thromboembolism, major bleeding, all-cause mortality, and cardiovascular death occurred in 110 (1.5%), 121 (1.7%), 168 (2.3%), and 60 (0.8%) patients, respectively. For each 1% increase in systolic BP-TTR, all adverse event risks decreased significantly in the uncorrected model, but when adjusted for known confounders and systolic BP at the time point closest to the event, there was a significant association only for cardiovascular death (adjusted HR 0.983 [95% CI 0.971-0.995]) p=0.006). On the other hand, each 1% increase in systolic BP time within the sub-target range of <110 mmHg was associated with a significantly increased risk of thromboembolism (HR 1.014 [95%CI 1.005-1.024: p=0.002]).
Dr.Kodani and colleagues summarize, "Systolic BP-TTR and systolic BP time within the sub-target range may be useful in assessing the risk of cardiovascular death and thromboembolism in patients with non-valvular atrial fibrillation, respectively."
Kodani E, et al. Am J Cardiol. 2022; 180: 52-58
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