| アブストラクト | Hypertension is an important risk factor for non-valvular atrial fibrillation (NVAF) and its prognosis. However, there is no study to clarify the impact of pre-existing hypertension and BP control status before the onset of AF on the prognosis after the onset of AF. This retrospective real-world cohort analysis used data from the Japan Medical Data Center Co., Ltd database. The presence of NVAF and hypertension, plus the occurrence of adverse events, was based on ICD-10 codes in the database. The primary composite AF-related cardiovascular event end point included ischemic stroke, hemorrhagic stroke, and acute myocardial infarction. Of the 21 523 patients identified as having new-onset NVAF between January 2005 and June 2016, 7885 had blood pressure (BP) data before the onset of NVAF available and were included in the analysis (4001 with pre-existing hypertension and 3884 without pre-existing hypertension). The rate of primary composite end point events was 10.3 and 4.4 per 1000 patient-years in patients with and without hypertension, respectively (P < .001). In addition, lower systolic BP (<120 mm Hg) before the onset of NVAF was associated with a lower incidence of cardiovascular events after the development of NVAF (P < .001). This highlights the importance of earlier and tighter 24-hour BP control before the onset of NVAF in patients with hypertension, not only for reducing the occurrence of new-onset of NVAF, but also for reducing both hemorrhagic and ischemic cardiovascular events after the onset of NVAF. |
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| ジャーナル名 | Journal of clinical hypertension (Greenwich, Conn.) |
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| 投稿日 | 2019/12/10 |
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| 投稿者 | Kario, Kazuomi; Abe, Toru; Kanegae, Hiroshi |
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| 組織名 | Jichi Medical University School of Medicine, Tochigi, Japan.;Genki Plaza Medical Center for Health Care, Tokyo, Japan. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/31816154/ |
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