Blood Pressure and Brain Lesions in Patients With Atrial Fibrillation.

Aeschbacher, Stefanie; Blum, Steffen; Meyre, Pascal B.; Coslovsky, Michael; Vischer, Annina S.; Sinnecker, Tim; Rodondi, Nicolas; Beer, Jürg H.; Moschovitis, Giorgio; Moutzouri, Elisavet; Hunkeler, Christof; Burkard, Thilo; Eken, Ceylan; Roten, Laurent; Zuern, Christine S.; Sticherling, Christian; Wuerfel, Jens; Bonati, Leo H.; Conen, David; Osswald, Stefan; ... (2021). Blood Pressure and Brain Lesions in Patients With Atrial Fibrillation. Hypertension, 77(2), pp. 662-671. Lippincott Williams & Wilkins 10.1161/HYPERTENSIONAHA.120.16025

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The association of blood pressure (BP) and hypertension with the presence of different types of brain lesions in patients with atrial fibrillation is unclear. BP values were obtained in a multicenter cohort of patients with atrial fibrillation. Systolic and diastolic BP was categorized in predefined groups. All patients underwent brain magnetic resonance imaging and neurocognitive testing. Brain lesions were classified as large noncortical or cortical infarcts, small noncortical infarcts, microbleeds, or white matter lesions. White matter lesions were graded according to the Fazekas scale. Overall, 1738 patients with atrial fibrillation were enrolled in this cross-sectional analysis (mean age, 73 years, 73% males). Mean BP was 135/79 mm Hg, and 67% of participants were taking BP-lowering treatment. White matter lesions Fazekas ≥2 were found in 54%, large noncortical or cortical infarcts in 22%, small noncortical infarcts in 21%, and microbleeds in 22% of patients, respectively. Compared with patients with systolic BP <120 mm Hg, the adjusted odds ratios (95% CI) for Fazekas≥2 was 1.25 (0.94–1.66), 1.41 (1.03–1.93), and 2.54 (1.65–3.95) among patients with systolic BP of 120 to 140, 140 to 160, and ≥160 mm Hg (P for linear trend<0.001). Per 5 mm Hg increase in systolic and diastolic BP, the adjusted β-coefficient (95% CI) for log-transformed white matter lesions was 0.04 (0.02–0.05), P<0.001 and 0.04 (0.01–0.06), P=0.004. Systolic BP was associated with small noncortical infarcts (odds ratios [95% CI] per 5 mm Hg 1.05 [1.01–1.08], P=0.006), microbleeds were associated with hypertension, but large noncortical or cortical infarcts were not associated with BP or hypertension. After multivariable adjustment, BP and hypertension were not associated with neurocognitive function. Among patients with atrial fibrillation, BP is strongly associated with the presence and extent of white matter lesions, but there is no association with large noncortical or cortical infarcts.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine

UniBE Contributor:

Rodondi, Nicolas; Moutzouri Beifuss, Elisavet and Roten, Laurent

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0194-911X

Publisher:

Lippincott Williams & Wilkins

Funders:

[4] Swiss National Science Foundation ; [192] Swiss Heart Foundation = Schweizerische Herzstiftung

Language:

English

Submitter:

Christine Baumgartner

Date Deposited:

06 Jan 2021 16:32

Last Modified:

13 Mar 2021 19:57

Publisher DOI:

10.1161/HYPERTENSIONAHA.120.16025

PubMed ID:

33356398

BORIS DOI:

10.48350/150463

URI:

https://boris.unibe.ch/id/eprint/150463

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