Poor blood pressure control increases stroke risk in patients with atrial fibrillation

Poor blood pressure control among patients with atrial fibrillation is associated with a 50-percent increased risk of stroke, according to an analysis presented by Duke Medicine researchers.

The findings, presented in a poster Saturday, March 29, 2014, at the American College of Cardiology meeting in Washington, D.C., suggest that hypertension should be carefully monitored and controlled among patients with atrial fibrillation.

Using data from a large clinical trial called ARISTOTLE, the Duke researchers analyzed more than 18,000 patients with atrial fibrillation to understand how high blood pressure affects their health.

Strokes were more common in atrial fibrillation patients who had a history of high blood pressure, or who had high blood pressure at the start of the study. A significant increase in the risk of stroke was also seen in patients who had high blood pressure measurements at any point during the study.

"This study is unique in that we looked at patients with atrial fibrillation who had a history of high blood pressure, patients who had high blood pressure measurement at the start of the study, and blood pressure control during the course of the study," said lead author Meena Rao, M.D., MPH, research fellow at the Duke Clinical Research Institute.

"We found that having high blood pressure at any point during the trial led to an increased risk of stroke by approximately 50 percent in patients with atrial fibrillation," Rao said. "This highlights the importance of blood pressure control in addition to anticoagulation to reduce the risk of stroke in patients with atrial fibrillation."

The ARISTOTLE trial, led by DCRI researchers, studied two anticoagulant drugs for treating atrial fibrillation, an abnormal heart rhythm that can result in the formation of blood clots and cause stroke.