ORIGINAL RESEARCH
Impact of Blood Pressure Control on Thromboembolism and Major Hemorrhage in Patients With Nonvalvular Atrial Fibrillation: A Subanalysis of the J-RHYTHM Registry Eitaro Kodani, MD, PhD; Hirotsugu Atarashi, MD, PhD; Hiroshi Inoue, MD, PhD; Ken Okumura, MD, PhD; Takeshi Yamashita, MD, PhD; Toshiaki Otsuka, MD, PhD; Hirofumi Tomita, MD, PhD; Hideki Origasa, PhD; on behalf of the J-RHYTHM Registry Investigators*
Background-—To clarify the influence of hypertension and blood pressure (BP) control on thromboembolism and major hemorrhage in patients with nonvalvular atrial fibrillation, a post hoc analysis of the J-RHYTHM Registry was performed. Methods and Results-—A consecutive series of outpatients with atrial fibrillation was enrolled from 158 institutions. Of 7937 patients, 7406 with nonvalvular atrial fibrillation (70.8% men, 69.810.0 years) were followed for 2 years or until an event occurred. Hypertension was defined as a systolic BP ≥140 mm Hg, a diastolic BP ≥90 mm Hg, a history of hypertension, and/or antihypertensive drug use. Hypertension was an independent risk factor for major hemorrhage (hazard ratio 1.52, 95% CI 1.05– 2.21, P=0.027) but not for thromboembolism (hazard ratio 1.05, 95% CI 0.73–1.52, P=0.787). When patients were divided into quartiles according to their systolic BP at the time closest to the event or at the end of follow-up (Q1,
Impact of Blood Pressure Control on Thromboembolism and Major Hemorrhage in Patients With Nonvalvular Atrial Fibrillation: A Subanalysis of the J-RHYTHM Registry Eitaro Kodani, MD, PhD; Hirotsugu Atarashi, MD, PhD; Hiroshi Inoue, MD, PhD; Ken Okumura, MD, PhD; Takeshi Yamashita, MD, PhD; Toshiaki Otsuka, MD, PhD; Hirofumi Tomita, MD, PhD; Hideki Origasa, PhD; on behalf of the J-RHYTHM Registry Investigators*
Background-—To clarify the influence of hypertension and blood pressure (BP) control on thromboembolism and major hemorrhage in patients with nonvalvular atrial fibrillation, a post hoc analysis of the J-RHYTHM Registry was performed. Methods and Results-—A consecutive series of outpatients with atrial fibrillation was enrolled from 158 institutions. Of 7937 patients, 7406 with nonvalvular atrial fibrillation (70.8% men, 69.810.0 years) were followed for 2 years or until an event occurred. Hypertension was defined as a systolic BP ≥140 mm Hg, a diastolic BP ≥90 mm Hg, a history of hypertension, and/or antihypertensive drug use. Hypertension was an independent risk factor for major hemorrhage (hazard ratio 1.52, 95% CI 1.05– 2.21, P=0.027) but not for thromboembolism (hazard ratio 1.05, 95% CI 0.73–1.52, P=0.787). When patients were divided into quartiles according to their systolic BP at the time closest to the event or at the end of follow-up (Q1,
