Poorly Controlled Hypertension Can Increase Stroke Risk by 50%

In 2011, the results of the pivotal ARISTOTLE trial found that apixaban is superior to warfarin in preventing stroke or systemic embolism, with less bleeding and lower mortality risk, in patients with nonvalvular atrial fibrillation. Four years later, the ARISTOTLE investigators have revisited this data and uncovered another significant finding in the trial data: poorly controlled hypertension may increase the risk of stroke in patients with atrial fibrillation by as much as 50%.

Led by Meena Rao, MD, researchers from Duke Clinical Research Institute presented the results of the first study of its kind to find that having high blood pressure at any point significantly increases the risk of stroke in atrial fibrillation patients. Whereas other studies have focused on history of hypertension in atrial fibrillation, the team of researchers analyzed how blood pressure control at the start of and during the study period affected stroke risk in more than 18,000 participants in ARISTOTLE.
_______________________________________________________________________________________________________________________________________________________________

RELATED CONTENT
Treatment Choices for Severe Hypertension
AFib Doubles Risk of Heart Attack in Women
_______________________________________________________________________________________________________________________________________________________________

“In addition to treating with anticoagulants to prevent blood clots, controlling blood pressure in patients with atrial fibrillation is very important to lower the risk of stroke,” said Rao in a Duke press release. “We tend to focus on the use of anticoagulants in these patients, but this study reminds us that blood pressure control is also important for these high-risk patients.”

Additionally, the subanalysis supported the key finding of ARISTOTLE such that the benefits of apixiban when compared with warfarin were consistent regardless of blood pressure control.

The study by Rao and colleagues was presented during the American College of Cardiology 2014 Scientific Sessions, which were held March 29-31, in Washington, DC.

-       Allison Musante, ELS

Reference

Elevated blood pressure increases the risk of stroke for AF patients, new ARISTOTLE review finds [news release]. Duke Medicine News and Communications. Published March 29, 2014. https://www.dcri.org/research/news/2014-news-archives/acc-2014-poorly-controlled-blood-pressure-at-any-time-increases-the-risk-of-stroke-for-af-patients-new-aristotle-review-finds. Accessed April 2, 2014.