Impact of baseline blood pressure on all-cause mortality in patients with atrial fibrillation:results from a multicenter registry study

作     者：Wei Xu Qirui Song Han Zhang Juan Wang Xinghui Shao Shuang Wu Jun Zhu Jun Cai Yanmin Yang 

作者机构：Emergency CenterFuwai HospitalState Key Laboratory of Cardiovascular Disease of ChinaNational Center for Cardiovascular DiseasesNational Clinical Research Center of Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Hypertension CenterFuwai HospitalState Key Laboratory of Cardiovascular Disease of ChinaNational Center for Cardiovascular Diseases of ChinaNational Clinical Research Center of Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2023年第136卷第6期

页      面：683-689页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：supported by Capital’s Funds for Research and Application of Clinical Diagnosis and Treatment Technology(Z191100006619121) High-level Hospital Clinical Research Funds(2022-GSP-GG-26) 

主　　题：All-cause death All-cause mortality Atrial fibrillation Blood pressure Diastolic blood pressure Hypertension Systolic blood pressure 

摘      要：Background:The ideal blood pressure(BP)target for patients with atrial fibrillation(AF)is still unclear.The present study aimed to assess the effect of the baseline BP on all-cause mortality in patients with AF.Methods:This registry study included 20 emergency centers across China and consecutively enrolled patients with AF from 2008 to 2011.All participants were followed for 1 year±1 month.The primary endpoint was all-cause mortality.Results:During the follow-up,276(13.9%)all-cause deaths occurred.Kaplan-Meier curves showed that a systolic blood pressure(SBP)
110 mmHg or160 mmHg was associated with a higher risk of all-cause mortality(log-rank test,P=0.014),and a diastolic blood pressure(DBP)70 mmHg was associated with the highest risk of all-cause mortality(log-rank test,P=0.002).After adjusting for confounders,the multivariable Cox regression model suggested that the risk of all-cause mortality was increased in the group with SBP
110 mmHg(hazard ratio[HR],1.963;95%confidence interval[CI],1.306-2.951),and DBP70 mmHg(HR,1.628;95%CI,1.163-2.281).In the restricted cubic splines,relations between baseline SBP or DBP and all-cause mortality showed J-shaped associations(non-linear P0.001 and P=0.010,respectively).The risk of all-cause mortality notably increased at a lower baseline SBP and DBP.Conclusions:Having a baseline SBP
110 mmHg or DBP70 mmHg was associated with a significantly higher risk of all-cause mortality in patients with AF.An excessively low BP may not be an optimal target for patients with AF.