RELATIONSHIP BETWEEN OFFICE BLOOD PRESSURE AND 24-HOUR AMBULATORY BLOOD PRESSURE MEASUREMENTS IN PATIENTS WITH PERSISTENT ATRIAL FIBRILLATION VERSUS SINUS RHYTHM

초록

Objective: The measurement of blood pressure (BP) in atrial fibrillation (AF) is considered to be difficult and uncertain, and the use of 24-hour ambulatory blood pressure monitoring (24-h ABPM) in patients with AF has been questioned. The aim of this study was to investigate and compare the relationships between automated office BP and 24-h ABP in hypertensive patients with persistent AF and sinus rhythm (SR). Design and Method: Between January 2010 and December 2015, 77 patients with persistent AF (mean age 65.0 ± 11.5 years, 50% men) and 118 age- and sex-matched hypertensive subjects with SR who underwent 24-h ABPM were enrolled. Results: Office heart rate (HR) was higher in AF patients (P = 0.010), and diastolic BP (DBP) and HR variability values of 24-h, daytime and nighttime were significantly higher in AF than in SR patients (all P < 0.0001). In AF patients, office BP were significantly correlated with 24-h ABP (r = 0.632, P < 0.0001 for SBP, r = 0.656, P < 0.0001 for DBP). However, compared to SR subjects, AF patients showed significantly higher mean differences between office BP measurements and 24-h ABP profiles in 24-h SBP (Δ11.3 ± 21.2 mmHg vs. Δ5.0 ± 17.4 mmHg, P = 0.025), daytime SBP (Δ8.5 ± 21.1 mmHg vs. Δ2.5 ± 17.4, P = 0.038), 24-h HR (Δ8.1 ± 15.2 mmHg vs. Δ3.3 ± 9.7, P = 0.016) and daytime HR (Δ6.2 ± 15.5 mmHg vs. Δ0.8 ± 9.5 mmHg, P = 0.008), whereas not in DBP values. Conclusions: These findings suggest that 24-h ABPM can be useful method to assess BP and minimize errors in overestimation of BP, frequently observed in office BP measurements, in patients with AF.