Hypertension — a significant risk factor for recurrent stroke in patients with atrial fibrillation

Abstract

Objective. The purpose of research was to study the indicators of daily monitoring of blood pressure (ABPM) in post-stroke patients with atrial fibrillation (AF) and their relationship to mortality. Design and methods. We included 350 stroke survivors with non-valvular AF. The patients were divided into 3 groups according to the stroke severity assessed by NIHSS (National Institutes of Health Stroke Scale). All patients underwent ABPM at baseline, at 3‑and 6‑month follow-up. Results. By the time of stroke onset, 72% of patients have already had AF, in 28% patient AF was newly verified. Systolic (SBP) and diastolic blood pressure (DBP) was significantly (p < 0,05) higher in patients with paroxysmal AF (n = 109), they had significantly (p < 0,05) lower degree of blood pressure (BP) decrease at baseline, 3 and 6 months. At 6 months, the group of patients with paroxysmal AF included 96 people, 13 patients (3,7%) died: 4 (2,6%) in group I; 3 (2,5%) — in group II, and 6 (7,7%) in group III. In the subgroup of died patients, there was a significant correlation (r = 0,56, p < 0,05) between insufficient nocturnal BP decline and the incidence of paroxysmal AF. Conclusions. Our findings suggest an independent contribution of the abnormal daily BP profile to the increased frequency of night AF episodes and its association with high mortality in post-stroke patients.