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Sudden steep drop in blood pressure on standing from lying down may predict atrial fibrillation
Date:11/20/2013

ision of General Internal Medicine at the Johns Hopkins University School of Medicine. "We want this on their radar screens."

For the study, the researchers followed 12,071 African-American and white men and women ages 45 to 64 years who were enrolled in the Atherosclerosis Risks in Communities (ARIC) study. From 1987 to 1989, each subject had a baseline visit during which information on socioeconomic indicators, medical history, family history, cardiovascular disease risk factors, serum chemistries, electrocardiograms (ECGs), medication use and anthropometrics was collected. Three follow-up visits were conducted, as well as annual telephone interviews and active surveillance of hospitalizations and death.

Five percent of the subjects (603 of them) were diagnosed with a rapid drop in blood pressure when going from lying down to standing up. The authors defined orthostatic hypotension as a 20 mmHg or greater drop in systolic blood pressure or a dip of at least 10 mmHg in diastolic pressure. Those who had a history or symptoms of atrial fibrillation at baseline were excluded from the study.

During an average follow-up of 18.1 years, 1,438 (11.9 percent) of the study participants developed atrial fibrillation. Those with orthostatic hypotension, after accounting for factors such as race, age, gender and other common risk factors for the arrhythmia, were 40 percent more likely than those without orthostatic hypotension to develop an irregular heartbeat. Atrial fibrillation was identified by 12-lead ECGs recorded during three follow-up visits at three-year intervals through 1998, and by hospitalizations and/or death certificates through 2010.

The 40 percent increased risk associated with atrial fibrillation for patients with fluctuating blood pressure was the same increase in risk associated with subjects who had diabetes or high blood pressure.

Atrial fibrillation is the most common type of arrhythmia, or problem with the rat
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
Johns Hopkins Medicine
Source:Eurekalert

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