Relationship between screening-detected atrial fibrillation and blood pressure levels in elderly hypertensive patients: The OMRON Heart Study

Background: Hypertension is a well-known risk factor for atrial fibrillation (AF) and strokes, but studies assessing screening-detected AF in hypertensive populations and its relationship to the blood pressure (BP) are scarce. Method: We prospectively recruited hypertensive patients (aged≥60) from all over Japan in a decentralized clinical trial. Participants were asked to measure their electrocardiogram (ECG) and BP at home for three months with a BP monitor equipped with ECG. Results: Between April 2022 and July 2023, 4,078 hypertensive patients from across the country participated in this study. The mean age was 66.3±5.5 years, and the male proportion was 80.3%. After excluding those with no measurement data (n=258), AF detection was 5.8% (n=220/3,820), and the time to AF detection was 3-109 days (median 28days). The mean BP at baseline was 133±14/85±9 mmHg in the morning and 125±14/79±9 mmHg in the evening. AF detection did not significantly differ between the baseline BP categories (log rank test, p=0.54), with hazard ratios (95% confidence interval) of 0.83 (0.57-1.19), 0.79 (0.55-1.14), and 0.99 (0.59-1.68) for SBP 135-144 and/or DBP 85-89, SBP 145-159 and/or DBP 90-99, and SBP≥160 and/or DBP≥100, respectively (SBP≤134 and DBP≤84 as a reference). The results did not change when taking into account the impact of the measurement rates and antihypertensive drugs on AF detection during the observation period. Conclusion: Detection of undiagnosed AF was 5.8% in elderly hypertensives, with no significant differences between the baseline BP categories and no effect of the measurement rate or antihypertensive drugs.

Publication History

Received: 11 June 2024

Accepted after revision: 23 November 2024

Accepted Manuscript online:
25 November 2024