Most Read Articles
13 Oct 2017
Higher circulating levels of docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA) appear to be protective against incident atherothrombotic and cardioembolic strokes, respectively, according to a recent study.
Roshini Claire Anthony, 11 Oct 2017

The prevalence of resistant hypertension may be lower than expected, particularly once pseudo-resistant hypertension due to treatment nonadherence is taken into account, according to a presentation at the recent APCH 2017.

Pank Jit Sin, 07 Jan 2015

Cardiovascular diseases (CVD) have been the main cause of death in the Malaysian population since 2007. This trend has continued, with the number of people dying from CVD-related causes increasing year on year. 

Tristan Manalac, 12 Oct 2017
Administration of a long-acting medication at the time that is most suitable for maximum patient compliance is the best approach in controlling blood pressure, said Dr. Trefor Morgan at the recently concluded 13th Asian-Pacific Congress of Hypertension (APCH 2017), held at the Suntec Singapore Convention and Exhibition Centre.

Orthostatic hypertension frequently occurs in AF patients

18 Jul 2017

There appears to be an association between orthostatic hypertension (OH) and atrial fibrillation (AF), according to a study suggesting that such association potentially reflects the role of the autonomic nervous system (ANS) in both AF and OH.

The study used data from the first wave of The Irish Longitudinal Study on Ageing, including a total of 4,408 participants aged ≥50 years. Beat-to-beat blood pressure was measured during active stand lasting 110 seconds. OH, which was defined as a fall in systolic blood pressure (SBP; ≥20 mmHg) or in diastolic blood pressure (DBP; ≥10 mmHg), was assessed at 30, 60 and 90 seconds. Initial OH was evaluated as a drop in SBP ≥40 mmHg or a drop in diastolic BP≥20 mmHg.

Of the participants, 101 had AF. Logistic regression analysis showed that compared with those without the condition, individuals with AF were more likely to have OH at 30 seconds (odds ratio [OR], 1.95; 95 percent CI, 1.24 to 3.06) and at 60 seconds (OR, 2.13; 1.18 to 3.87), as well as initial OH (OR, 1.81; 1.21 to 2.70).

The association seen between initial OH and OH at 30 seconds remained significant despite adjustment for potential confounders such as age, sex, baseline heart rate, education, blood pressure, smoking, frailty, beta blocker use, antihypertensive use and number of cardiovascular (CV) conditions.

Age-related changes in CV structure and function potentially explain the association between AF and OH, independent of comorbidities such as ischaemic heart disease. Another explanation is the ANS, which plays a role in the pathogenesis of both AF and OH. Via the baroreceptors, the ANS controls initial restoration of BP on stand. [Circulation 2003;107:139–46]

A recent study suggests that AF is related to the impairment of the baroreflex, and repair of sinus rhythm improves baroreflex gain. This could explain the strong association between initial OH and AF observed in the present investigation, researchers said. [J Am Heart Assoc 2016;5:e002997]

Findings of the present study has clinical implications, including a potential increased risk of falls and syncope. There is evidence suggesting an association and AF and falls, and the coexistence of OH could further increase the risk of falls, researchers added.

Future studies should analyse baseline heart rate variability and baroreflex sensitivity to further explore the relationship between AF and OF, they said.

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Most Read Articles
13 Oct 2017
Higher circulating levels of docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA) appear to be protective against incident atherothrombotic and cardioembolic strokes, respectively, according to a recent study.
Roshini Claire Anthony, 11 Oct 2017

The prevalence of resistant hypertension may be lower than expected, particularly once pseudo-resistant hypertension due to treatment nonadherence is taken into account, according to a presentation at the recent APCH 2017.

Pank Jit Sin, 07 Jan 2015

Cardiovascular diseases (CVD) have been the main cause of death in the Malaysian population since 2007. This trend has continued, with the number of people dying from CVD-related causes increasing year on year. 

Tristan Manalac, 12 Oct 2017
Administration of a long-acting medication at the time that is most suitable for maximum patient compliance is the best approach in controlling blood pressure, said Dr. Trefor Morgan at the recently concluded 13th Asian-Pacific Congress of Hypertension (APCH 2017), held at the Suntec Singapore Convention and Exhibition Centre.