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Abstract

Background

The epidemiological data have linked atrial fibrillation (AF) risk with hypertension.

The surging wearable devices allow noninvasive beat-by-beat blood pressure monitoring.

Objective

The present study aimed to investigate dynamic changes on blood pressure with wearable blood pressure monitors and its-related risk for AF occurrence.

Methods

In the mobile Atrial Fibrillation Application (mAFA II) programme, the subjects used the photoplethysmography (PPG)-based smart devices to detect the AF episodes. They simultaneously freely decided whether to take the wearables to monitor their blood pressure.

Results

There were 25388 subjects (mean age ± standard deviation, SD, 48±12 years old, 90.4% male) who received simultaneously blood pressure and cardiac rhythm monitoring with the wearables between Jan 1, 2022 and March 19, 2022. The monitored time (median, interquartile) were 6 (12–18) days and the number of measurements of blood pressure were 16 (3–56).

The 8830 subjects (34.8%, 8830/25388) monitored with average 24-hour BP >130/80 mm Hg and 945 subjects (10%, 945/8830) with pulse differential over 60 mmHg.

The extreme-dippers blood pressure and reverse-dippers blood pressure were in 8563 subjects (33.7%, 8563/25388) and 7018 subjects (27.6%, 7018/25388), respectively.

There were 498 subjects (58±12 years, 89% male) who identified with AF. After adjusting age, gender, diabetes, obstructive sleep apnea, heart failure, coronary artery disease, and hyperthyroidism, the average 24-hour BP >130/80 mm Hg (Odd ratio, OR, 95% confidential interval, CI, 1.38, 1.12–1.69, p=0.002), the reverse-dippers blood pressure (OR, 95% CI, 1.29, 1.07–1.56, p=0.008) and pulse differential over 60 mmHg (OR, 95% CI, 1.76,1.17–2.64, p=0.006) independently predicted the risk of AF.

Conclusion

Wearable devices with beat-by-beat monitoring demonstrated that not only high average 24-hour BP, but also reverse-dippers blood pressure and pulse differential over 60 mmHg increased AF susceptibility, which informing the clinical application of personalized “upstream risk control” of AF.

Funding Acknowledgement

Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Natural Science Foundation of China

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Reproduced from: European Heart Journal, Volume 43, Issue Supplement_2, October 2022, ehac544.2811, https://doi.org/10.1093/eurheartj/ehac544.2811 by permission of Oxford University Press on behalf of the European Society of Cardiology. The opinions expressed in the Journal item reproduced as this reprint are those of the authors and contributors, and do not necessarily reflect those of the European Society of Cardiology, the editors, the editorial board, Oxford University Press or the organization to which the authors are affiliated. The mention of trade names, commercial products or organizations, and the inclusion of advertisements in this reprint do not imply endorsement by the Journal, the editors, the editorial board, Oxford University Press or the organization to which the authors are affiliated. The editors and publishers have taken all reasonable precautions to verify drug names and doses, the results of experimental work and clinical findings published in the Journal. The ultimate responsibility for the use and dosage of drugs mentioned in this reprint and in interpretation of published material lies with the medical practitioner, and the editors and publisher cannot accept liability for damages arising from any error or omissions in the Journal or in this reprint. Please inform the editors of any errors. © The Author(s) 2022.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact [email protected]
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