A study conducted by UAB investigators has outlined the importance of strict blood pressure control in the development of atrial fibrillation, which can lead to poor outcomes such as stroke, heart attacks and death.
A new study published by University of Alabama at Birmingham researchers in the international journal Hypertension shows strict blood pressure control could reduce the risk of developing atrial fibrillation by 22 percent. However, even after strict blood pressure control, this heart rhythm abnormality can be deadly.
Vibhu Parcha, M.D., a physician-scientist in UAB’s Division of Cardiovascular Disease, explained that uncontrolled high blood pressure leads to the development of atrial fibrillation, making the control of blood pressure in these individuals very important. Atrial fibrillation is the most common heart rhythm abnormality frequently seen in patients with high blood pressure and can lead to stroke, heart failure and even death.
Parcha and the team of UAB cardiologists and hypertension researchers analyzed data from the NHLBI-sponsored SPRINT trial, in which UAB was a study site.
“We used the data from the largest hypertension trial to answer a question we commonly face as clinicians,” Parcha said. “Can we reduce the risk of development of this potentially fatal heart rhythm abnormality by a stringent control of blood pressure, and what can we do to reduce the risk of bad outcomes in patients who have this condition?”
Researchers found that adults can reduce their risk of developing atrial fibrillation by 22 percent through rigorous regulation of their systolic blood pressure to less than 120 mmHg. They also noted that, if one does develop atrial fibrillation, tighter control may not further reduce their risk for possibly serious cardiovascular disease events.
“Even after stringent blood pressure control to levels of less than 120/80 mmHg, the patients with atrial fibrillation have an 88 percent higher risk for poor outcomes,” Parcha said.
Senior author Pankaj Arora, M.D., assistant professor in UAB’s Division of Cardiovascular Disease, says the medical community needs to ensure that people with hypertension regularly monitor their blood pressure levels, as poorly controlled blood pressure may lead to the development of atrial fibrillation.
“The development of atrial fibrillation acts as a signal for both the patients and their health care team that we need to be cautious about the risk of serious cardiovascular events,” Arora said. “While blood pressure control helps improve the health risk in patients of atrial fibrillation, there is still a large residual risk due to underlying changes in the body that can contribute to the development of cardiovascular events.”
Arora adds that the development of atrial fibrillation in a hypertensive patient is reflective of the person’s having a high risk of stroke, heart failure, heart attack or death.
“We need to employ a comprehensive, multipronged approach to optimize the cardiovascular health of these high-risk patients,” Arora said. “We have seen in our other investigations from UAB that there is a high prevalence of hypertension in young adults nationally, and adequate blood pressure control in these young patients is needed so their risk for development of serious health events is reduced.”