Comparison Of ABPM And Office Blood Pressure In Hypertensive Patients With Atrial Fibrillation

Background:Atrial fibrillation is one of the most common persistent arrhythmias.As the incidence of hypertension increases year by year,hypertension has become a major risk factor for atrial fibrillation and increased risk of stroke in patients with atrial fibrillation.Strict control of blood pressure is particularly important for these patients,which also highlights the importance of blood pressure measurement.However,blood pressure measurement has always been an important issue for patients with atrial fibrillation,because their ventricular rate is extremely irregular,resulting in these patients often fluctuate in results when measuring blood pressure.This article aims to investigate Comparison of ABPM and Ambulatory Blood Pressure in Hypertensive Patients with Atrial Fibrillation.Methods:Continuous enrollment group from June 2017 to March 2018 in the Department of Cardiology,Second Affiliated Hospital,Nanchang University,87 patients with hypertension and atrial fibrillation,and improved 24-hour ambulatory blood pressure monitoring.On the same day,24-hour ambulatory blood pressure monitoring and mercury sphygmomanometer blood pressure measurements were performed,and relevant data were collected.Result:1.Comparing the two blood pressure measurement methods,the mean daytime systolic blood pressure of ABPM was(127.36 ± 12.14mmHg).The mean systolic blood pressure of mercury sphygmomanometer was(132.21±16.00mmHg).P value was(0.000).The difference was statistically significant(P<0.001).However,the mean daily diastolic blood pressure of ABPM was(75.49±10.11mmHg).The mean diastolic blood pressure of mercury sphygmomanometer was(76.49±11.32mmHg).P value was(0.270).The difference was not statistically significant(P>0.05).2.Two blood pressure measurements were compared in different genders.In male patients,the daytime mean systolic blood pressure of ABPM was(128.79±12.61mmHg).The mean systolic pressure of mercury sphygmomanometer was(134.48 ± 14.23mmHg).P value was(0.002).The difference was statistically significant(P<0.01).But the mean daytime diastolic blood pressure of ABPM was(75.09 ± 8.6mmHg).The mean diastolic blood pressure of mercury sphygmomanometer was(76.61±11.36mmHg).P value was(0.299).The difference was not statistically significant(P >0.05).In female patients,the daytime mean systolic pressure of ABPM was(125.88±11.59 mm Hg).The mean systolic pressure of mercury sphygmomanometer was(129.90 ± 11.47mmHg).P value was(0.062).The difference was not statistically different(P>0.05).The mean daytime diastolic blood pressure of ABPM was(75.91 ± 11.53mmHg).The mean diastolic blood pressure of the mercury sphygmomanometer was(76.49±11.32mmHg).P value was(0.683).The difference was not statistically different(P>0.05).The mean systolic blood pressure of ABPM is lower than that of the mercury sphygmomanometer.In male patients,this difference is more pronounced and statistically significant.Although there is a downward trend in female patients,it does not reach statistical significance.The mean diastolic pressure was not statistically significant.3.3.Two blood pressure measurement methods were compared at different ages;in patients aged ?65 years,the mean daytime systolic blood pressure of ABPM was(124.90 ± 13.14mmHg).The mean systolic blood pressure of mercury sphygmomanometer was(129.95 ± 15.00mmHg).P value was(0.02).the difference was statistically significant(P<0.05).But the mean daytime diastolic blood pressure of ABPM was(74.45±11.39mmHg).The mean diastolic blood pressure of mercury sphygmomanometer was(77.15±11.62mmHg).P value was(0.084),The difference was no statistical significance(P>0.05).In age>65 years,The mean daytime systolic pressure of ABPM was(128.48±11.66mmHg).The mean systolic pressure of mercury sphygmomanometer was(133.56 ±16.41 mm Hg).P value was(0.005).The difference was statistical significance(P<0.01).But the mean daily diastolic blood pressure of ABPM was(75.93 ± 9.52mmHg).The mean diastolic blood pressure of mercury sphygmomanometer(76.31±11.41mmHg).P value was(0.745).The difference was not statistical significance(P>0.05).The mean systolic blood pressure of ABPM is lower than that of the mercury sphygmomanometer.Therewere statistically significant differences in patients age?65 years and age>65 years,but they were more pronounced in age>65 years old patients and mean diastolic blood pressure.The mean diastolic pressure was not statistically significant.4.Comparison of the average heart rate of ABPM and self-rated heart rate found that during the day,the average heart rate of ABPM was(74.79±11.70 beats/min).The self-test average heart rate was(75.62±11.78 beats/min).The P value was(0.46).the difference was not statistical significance(P >0.05).5.Comparison of two blood pressure methods were different heart rates.In patients with heart rate <80 beats/min,the daytime mean systolic blood pressure of ABPM was(127.50 ± 11.80 mm Hg).The mean systolic blood pressure of mercury sphygmomanometer was(133.36 ± 16.68mmHg)).P value was(0.002).The difference was statistically significant(P <0.01).But the mean daytime diastolic blood pressure of ABPM(74.80±9.98mmHg).The mean diastolic blood pressure of mercury sphygmomanometer was(75.77±11.82mmHg).P value was(0.395).The difference was not statistically significant(P>0.05).In patients with HR ? 80beats/minute,the mean daytime systolic blood pressure of ABPM was(126.94 ±13.05mmHg).The mean systolic pressure of mercury sphygmomanometer was(130.73 ± 14.79mmHg).P value was(0.066).The difference was not statistically significant(P>0.05).But the mean daytime diastolic blood pressure of ABPM was(74.48 ± 10.46mmHg),the average diastolic blood pressure of the mercury sphygmomanometer was(77.90±10.79mmHg).P value was(0.381).The difference was not statistically significant(P>0.05).The mean daytime systolic blood pressure of ABPM was lower than the mean systolic blood pressure measured by the mercury sphygmomanometer.This difference was more pronounced statistically significant in patients with HR <80 beats/minute than the patients with HR ? 80 beats/min.Although there was a declining trend,it did not reach statistical significance.Daytime diastolic blood pressure was not statistically significant.6.Using linear correlation analysis,the results showed that ABPM was positively correlated with SBP(r=0,640,P<0.01),and DBP(r=0.707,P<0.01)was positively correlated with blood pressure measured by mercury sphygmomanometer.Conclusion:1.ABPM has good correlation with blood pressure measured by mercury sphygmomanometer.2.The daytime mean systolic blood pressure of ABPM was lower than that of the mercury sphygmomanometer(10.43 ± 5.05mmHg),and the mean diastolic blood pressure was not significantly different.3.ABPM can also be applied to patients with atrial fibrillation(ventricular rate <100beats/minute).