Faculty Collaboration Database

Association between blood pressure levels and premature atrial contractions in patients with hypertension. Am J Med Sci 2024 Oct;368(4):341-345

Date

06/03/2024

Pubmed ID

38825075

DOI

10.1016/j.amjms.2024.05.022

Scopus ID

2-s2.0-85195449691 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

BACKGROUND: High blood pressure (BP) induces left atrial structural and functional remodeling that increases susceptibility to atrial arrhythmia. We hypothesized that lower systolic BP (SBP) levels are associated with a lower prevalence of premature atrial contractions (PACs) in patients with hypertension.

METHODS: This analysis included 4,697 participants (mean age 62±13.1 years, 50% women, 25.6% blacks) with hypertension from the Third National Health and Nutrition Examination Survey who did not have a prior history of cardiovascular disease (CVD). Multivariable logistic regression was used to examine the cross-sectional association between SBP and prevalence of PACs ascertained from 12-lead resting electrocardiograms. Multivariable Cox proportional hazard analysis was used to examine the association between baseline PACs and CVD mortality.

RESULTS: Approximately 1.6% (n=74) of participants had baseline PACs. Patients with SBP ≤140 mmHg had a lower prevalence of PACs than those with SBP ≥140 mmHg (1.1% vs. 1.9%, p-value=0.01). In a multivariable logistic regression model, each 10 mmHg decrease in SBP was associated with a 12% lower odds of PACs (OR (95%CI): 0.88 (0.77-0.99)). During 14 years of follow-up, 645 CVD deaths occurred. In a multivariable-adjusted Cox model, presence of PACs was associated with a 78% increased risk of CVD mortality (HR (95%CI): 1.78 (1.23-2.60)).

CONCLUSIONS: In patients with hypertension, lower SBP levels are associated with a lower prevalence of PACs, and presence of PACs is associated with a higher risk of CVD mortality risk. These findings highlight the potential role of BP lowering in the management of cardiac arrhythmias.

Author List

Mostafa MA, Soliman MZ, Li Y, Singleton MJ, Ahmad MI, Soliman EZ

Author

Muhammad Imtiaz Ahmad MBBS Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Atrial Premature Complexes
Blood Pressure
Cross-Sectional Studies
Female
Humans
Hypertension
Male
Middle Aged
Nutrition Surveys
Prevalence