[The impact of hypertension history and baseline blood pressure levels on the cardiovascular outcomes in Chinese emergency atrial fibrillation patients]

Abstract

Objective: To explore the impact of hypertension history and baseline blood pressure levels on cardiovascular outcomes in Chinese emergency atrial fibrillation patients during 1 year follow-up.

Methods: This prospective study consecutively enrolled patients presenting to an emergency department with atrial fibrillation from 20 hospitals in China during November 2008 to October 2011. Baseline data and treatment regimen were recorded, all patients were followed up for one year, and major cardiovascular events (MACE including cardiovascular death, stroke, myocardial infarction, and non central nervous systemic embolism) were recorded. Patients were divided into hypertension history group and non-hypertension history group. Univariate Cox analysis was evaluated hypertension history, baseline blood pressure on major cardiovascular events. Multivariate Cox analysis recognized risk factors for major cardiovascular events.

Results: A total of 2016 atrial fibrillation patients were enrolled, and the average systolic blood pressure and diastolic blood pressure were (131.9 ± 23.3)mm Hg(1 mm Hg = 0.133kPa), (79.9 ± 14.7)mm Hg respectively. 1118 patients (55.5%) had a history of hypertension, and about 91.1% hypertension patient received antihypertensive treatment. Major cardiovascular events occurred in 314 cases (15.6%) among 1 year follow up, and 191 cases (17.1%) among hypertension group and 123 cases (13.7%) among non-hypertension group. Univariate Cox regression analysis of prognostic factors for major cardiovascular events showed that hypertension history and baseline systemic blood pressure were risk factors (HR = 1.269, 95%CI: 1.012-1.592, P = 0.039; HR = 1.005, 95%CI: 1.000-1.010, P = 0.042). Multivariate Cox regression model analysis, adjusted others risk factors, showed that hypertension history, baseline systolic pressure levels, and baseline diastolic blood pressure did not have independent predictive value for major cardiovascular events. Moreover, multivariate Cox regression analysis showed that age, history of heart failure, history of stroke were independent prognostic factor for one year follow-up of major cardiovascular events in atrial fibrillation patients.

Conclusion: Age, history of heart failure, history of stroke were independent predictor for 1 year major cardiovascular events in Chinese emergency atrial fibrillation patients.