Impact of AF Screening According to Systolic Blood Pressure Measures

In a recent randomized controlled trial, investigators evaluated associations between hypertensive systolic blood pressure (SBP) measures and screening for atrial fibrillation. Their article, published in Hypertension, reported that screening among patients with SBP ≥150 mm Hg was associated with a significant reduction in thromboembolic events.

This analysis was performed as a substudy of the LOOP Study, which evaluated atrial fibrillation screening using an implantable loop recorder (ILR)—plus subsequent anticoagulation if an atrial fibrillation episode of six or more minutes was detected—versus usual care in an elderly population with risk factors for stroke. Outcomes were based on time-to-event Cox models.

Adverse Events Reduced With Atrial Fibrillation Screening by SBP

Notably, the researchers found the hazard ratio (HR) for stroke or systemic arterial embolism decreased for the ILR group compared to the control group as patient SBP measures increased. Reportedly, ILR screening achieved a 44% risk reduction in patients with SBP (adjusted [a]HR, 0.56; 95% CI, 0.37-0.83).

Additionally, compared to those with a lower SBP, patients in the ILR group with SBP ≥150 mm Hg were associated with increased atrial fibrillation episode incidence (aHR, 1.70; 95% CI, 1.08-2.69), but not with increased overall incidence of atrial fibrillation (P>.05).

Overall, the authors suggested that ILR screening for atrial fibrillation in a high-risk, elderly population was significantly effective for reducing thromboembolic events. Ultimately, they suggested that their results “should be considered hypothesis-generating and warrant further study.”

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