Ambulatory Blood Pressure Monitoring in Atrial Fibrillation

Lip, Gregory Y.H.; Zarifis, John; Beevers, M.; Beevers, D. G.

doi:10.1016/s0002-9149(96)00293-7

Cited by 35 publications

(38 citation statements)

References 8 publications

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“…153 However prolonged (2 to 24 hours) ambulatory observations do provide data similar to that in subjects with normal cardiac rhythm. 154,155 Sometimes, an intra-arterial blood pressure is necessary to get a baseline for comparison. If severe regular bradycardia is present (eg, 40 to 50 bpm), deflation should be slower than usual to prevent underestimation of systolic and overestimation of diastolic blood pressure.…”

Section: Arrhythmiasmentioning

confidence: 99%

Recommendations for Blood Pressure Measurement in Humans and Experimental Animals

Pickering¹,

Hall²,

Appel³

et al. 2005

Hypertension

2,024

963

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Abstract-Accurate measurement of blood pressure is essential to classify individuals, to ascertain blood pressure-related risk, and to guide management. The auscultatory technique with a trained observer and mercury sphygmomanometer continues to be the method of choice for measurement in the office, using the first and fifth phases of the Korotkoff sounds, including in pregnant women. The use of mercury is declining, and alternatives are needed. Aneroid devices are suitable, but they require frequent calibration. Hybrid devices that use electronic transducers instead of mercury have promise. The oscillometric method can be used for office measurement, but only devices independently validated according to standard protocols should be used, and individual calibration is recommended. They have the advantage of being able to take multiple measurements. Proper training of observers, positioning of the patient, and selection of cuff size are all essential. It is increasingly recognized that office measurements correlate poorly with blood pressure measured in other settings, and that they can be supplemented by self-measured readings taken with validated devices at home. There is increasing evidence that home readings predict cardiovascular events and are particularly useful for monitoring the effects of treatment. Twenty-four-hour ambulatory monitoring gives a better prediction of risk than office measurements and is useful for diagnosing white-coat hypertension. There is increasing evidence that a failure of blood pressure to fall during the night may be associated with increased risk. In obese patients and children, the use of an appropriate cuff size is of paramount importance.

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Section: Arrhythmiasmentioning

confidence: 99%

Recommendations for Blood Pressure Measurement in Humans and Experimental Animals

Pickering¹,

Hall²,

Appel³

et al. 2005

Hypertension

2,024

963

View full text Add to dashboard Cite

show abstract

“…However, few studies of hypertension and coexisting AF using ambulatory BP monitoring (ABPM) have been reported. 16,17 In many patients with AF, it is difficult to obtain accurate BP measurements. 18 In the present study, therefore, the BP measurements were performed by ABPM and home BP in hypertensive patients with paroxysmal AF who were in normal sinus rhythm ClinicalTrials.gov number NCT01748253.…”

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confidence: 99%

Dose Timing of an Angiotensin II Receptor Blocker/Calcium Channel Blocker Combination in Hypertensive Patients With Paroxysmal Atrial Fibrillation

Kario

Uchiyama²,

Yoshida³

et al. 2016

J of Clinical Hypertension

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It has long been thought that there is a close association between hypertension and atrial fibrillation (AF). However, the efficacy of an angiotensin II receptor blocker for the prevention of organ damage in hypertensive individuals with AF is still controversial. The present study was a multicentered, prospective, randomized, open-label clinical trial investigating the differences in the effect of treatment with telmisartan/amlodipine combination tablets on blood pressure (BP) levels and BP variability between morning and bedtime administration in hypertensive patients with paroxysmal AF, using ambulatory BP monitoring (ABPM) and home BP. With this treatment, the patients' 24-hour BP, nighttime BP, preawake BP, and morning BP shown by ABPM were significantly reduced, and the antihypertensive effects were similar regardless of the timing of the drug administration. The standard deviation of day-by-day home systolic BP and the maximum home systolic BP were also significantly reduced, and these effects were similar regardless of the treatment timing. The N-terminal pro-brain natriuretic peptide level was significantly decreased only in the bedtime administration group. A larger study will demonstrate whether the bedtime administration of telmisartan/amlodipine combination tablets maximizes the risklowering effect against AF recurrence in paroxysmal AF hypertensive patients. J Clin Hypertens (Greenwich). 2016;18:1036-1044. ª 2016 Wiley Periodicals, Inc.A close association between hypertension and atrial fibrillation (AF) has long been suspected. The Framingham Heart Study 1 showed that hypertension was an independent risk factor for incident AF in a general population, and uncontrolled elevated blood pressure (BP) was associated with an increased risk of incident AF in patients treated for hypertension.2 Based on overseas clinical trials, the main etiology of AF is hypertension in approximately 60% of AF patients.3 In addition, the Suita Study, 4 a cohort study in Japan, showed that hypertension was associated with an increased risk of incident AF.It is also suspected that hypertension not only facilitates the onset and persistence of AF, but also raises the risk of a thromboembolism. Antihypertensive treatment is therefore considered essential for hypertensive individuals with AF to prevent recurrent AF, cerebral infarction, or heart failure. 5 In several countries, angiotensin II receptor blockers (ARBs) have attracted attention as a therapeutic drug for hypertensive individuals with AF.6-9 However, the Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events (ACTIVE I) 10 comparing the effect of irbesartan on patients with AF (mainly persistent and permanent types) with that of placebo showed no differences between irbesartan and placebo for the recurrence of AF, indicating that ARBs did not suppress the recurrence of AF. Valsartan also did not reduce the recurrent AF rate in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF...

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“…In a separate study, the clinical use of the SpaceLabs 90207 oscillometric ABPM device in outpatients with chronic AF was reported to be satisfactory, when used to assess blood pressure in stable outpatients with chronic AF. 19 So, is it goodbye mercury? Despite these data, the sceptics still insist that automated blood pressure monitoring should be used with caution in AF, as many automated machines are unable to generate reproducible and/or reliable readings with this arrhythmia.…”

mentioning

confidence: 99%