Screening for Atrial Fibrillation During Routine Automated Blood Pressure Measurement in General Population Aged 65 Years and Above: EMENO National Epidemiological Survey in Greece.

Abstract

Atrial fibrillation (AF) is common with advanced aging and is often asymptomatic and undiagnosed. A blood pressure (BP) monitor with embedded algorithm for detecting AF with high diagnostic accuracy during routine automated BP measurement was used to screen individuals aged ≥ 65 years. The EMENO health survey (2013-2016) applied a multi-stage stratified random sampling method to select a random general adult population sample in Greece. Participants aged ≥ 65 years were screened for AF using an automated oscillometric device with AF detecting algorithm (Microlife BPA100 Plus AFIB) with triplicate measurements on a single occasion. A total of 975 individuals with AF data on at least one BP measurement were analysed [(mean (SD) age 73.2 (6.6) years, men 45%, hypertensives 79.3%). AF was detected in all 3 BP readings in 65 individuals (6.3%, AF group), in none of 3 readings in 661 (73.6%, non-AF group), and in 1-2 readings of 3 or less readings in 249 (20.1%, uncertain AF group). AF group individuals were older (p < 0.001), had lower systolic BP (p < 0.05) and more frequent cardiovascular disease (p < 0.01) compared to the non-AF and uncertain AF group. Moreover, 44.6% were unaware of their AF and all required anticoagulant therapy (CHA2DS2-VASc ≥ 1/≥2, men/women). About 6% of individuals aged ≥ 65 years in Greece appeared to have AF, and 44.6% of them were unaware and requiring anticoagulant treatment. AF screening during routine automated BP measurement appears to be a useful tool for early detection of asymptomatic AF in individuals aged ≥ 65 years.