Blood pressure variability in hypertensive patients with atrial fibrillation in the VALUE trial

Figures & data

Table 1. Baseline characteristics of patients with or without atrial fibrillation at baseline, and of patients who developed or did not develop atrial fibrillation during follow-up.

	All patients (N = 13,827)			Patients with no atrial fibrillation at baseline (N = 13,486)
	No atrial fibrillation at baseline (n = 13,486)	Atrialfibrillationat baseline(n = 341)	P-value	No atrial fibrillation duringfollow-up(n = 12,939)	Non-persistentatrial fibrillationduring follow-up(n = 318)	Persistent atrialfibrillation duringfollow-up(n = 229)	P-value
Female gender	5738 (42.5)	122 (35.8)	0.01	5511 (42.6)	120 (37.7)	107 (46.7)	0.1
Age (years)	67.0 (8.1)	71.4 (7.0)	<0.0001	66.8 (8.0)	70.3 (7.2)	70.7 (7.7)	<0.0001
Treatment with valsartan	6735 (49.9)	170 (49.9)	1.0	6485 (50.1)	157 (49.4)	93 (40.6)	0.02
Treatment with amlodipine	6751 (50.1)	171 (50.1)		6454 (49.9)	161 (50.6)	136 (59.4)
Number of visits (mean)	8.7 (1.7)	8.4 (2.0)	<0.0001	8.7 (1.7)	8.6 (1.7)	8.9 (1.4)	0.05
Ethnicity
Caucasian	12056 (89.4)	324 (95.0)	0.009	11534 (89.1)	300 (94.3)	222 (96.9)	<0.0001
Black	530 (3.9)	8 (2.3)		521 (4.0)	6 (1.9)	3 (1.3)
Asian	495 (3.7)	5 (1.5)		488 (3.8)	4 (1.3)	3 (1.3)
Other	405 (3.0)	4 (1.2)		396 (3.1)	8 (2.5)	1 (0.4)
Systolic blood pressure (mm Hg)	154.6 (19.0)	153. 9 (18.6)	0.5	154.5 (19.0)	158.0 (18.2)	160.1 (19.5)	<0.0001
Diastolic blood pressure (mm Hg)	87.6 (10.8)	88.7 (10.4)	0.06	87.6 (10.8)	87.1 (10.6)	86.7 (12.1)	0.3
Heart rate, beats/minute	72.2 (10.7)	75.1 (11.9)	<0.0001	72.2 (10.6)	70.7 (10.8)	70.3 (11.5)	0.04
Creatinine (µmol/L)	100.4 (23.1)	106.3 (24.7)	<0.0001	100.3 (23.1)	103.6 (22.1)	100.5 (19.9)	0.001
Diabetes mellitus	4528 (33.6)	134 (39.3)	0.03	4342 (33.6)	112 (35.2)	74 (32.3)	0.8
Smoking	3259 (24.2)	61 (17.9)	0.007	3153 (24.4)	62 (19.5)	44 (19.2)	0.03
Body-mass index (kg/m^2)	28.6 (5.0)	29.0 (5.4)	0.2	28.6 (4.9)	29.0 (4.9)	30.4 (7.5)	<0.0001
Left ventricular hypertrophy with strain	761 (5.6)	34 (10.0)	0.01	706 (5.5)	30 (9.4)	25 (10.9)	<0.0001
History of myocardial infarction	6166 (45.7)	162 (47.5)	0.5	5903 (45.6)	163 (51.3)	100 (43.7)	0.1
History of peripheral arterial disease	1850 (13.7)	56 (16.4)	0.2	1766 (13.6)	51 (16.0)	33 (14.4)	0.5
History of stroke/TIA	2634 (19.5)	92 (27.0)	0.001	2528 (19.5)	62 (19.5)	44 (19.2)	1.0
Mean systolic pressure during follow-up*	139.0 (11.1)	139.0 (10.9)	0.9	139.0 (11.1)	139.2 (11.3)	140.2 (11.5)	0.3

Data are numbers (%) or means (SD). P value according to chi-squared test for categorical variables or t-tests and one-way analysis of variance (ANOVA) for continuous variables.

*Mean systolic blood pressure from visit 6 to 15.

Figure 1. Standard deviation of visit-to-visit systolic blood pressure in patients with or without atrial fibrillation at baseline, and in patients who developed or did not develop atrial fibrillation during follow-up. Data are boxplots of median (solid horizontal line), interquartile range (box outline), minimum, and maximum (whiskers). Extreme values are not shown. No atrial fibrillation at baseline: mean SD 10.0 mm Hg (SD 5.1); Atrial fibrillation at baseline: mean SD 10.3 mm Hg (SD 5.6); No atrial fibrillation during follow-up: mean SD 9.9 mm Hg (SD 5.1); Non-persistent atrial fibrillation during follow-up: mean SD 11.1 mm Hg (SD 5.3); Persistent atrial fibrillation during follow-up: mean SD 11.7 mm Hg (SD 5.5).

Figure 2. Standard deviation of within-visit systolic blood pressure in patients with or without atrial fibrillation at baseline, and in patients who developed or did not develop atrial fibrillation during follow-up. Data are boxplots of median (solid horizontal line), interquartile range (box outline), minimum, and maximum (whiskers). Extreme values are not shown. No atrial fibrillation at baseline: mean SD 4.0 mm Hg (SD 2.1); Atrial fibrillation at baseline: mean SD 4.1 mm Hg (SD 2.3); No atrial fibrillation during follow-up: mean SD 4.0 mm Hg (SD 2.1); Non-persistent atrial fibrillation during follow-up: mean SD 4.1 mm Hg (SD 2.1); Persistent atrial fibrillation during follow-up: mean SD 4.3 mm Hg (SD 2.1).

Table 2. Difference in standard deviation of visit-to-visit systolic blood pressure between patients with and without atrial fibrillation at baseline and between patients who developed and did not develop atrial fibrillation during follow-up.

	All patients (N = 13,827)			Patients with no atrial fibrillation at baseline (N = 13,486)
	No atrial fibrillation at baseline (n = 13,486)	Atrialfibrillation atbaseline(n = 341)	P-value	No atrialfibrillation duringfollow-up(n = 12,939)	Non-persistent atrialfibrillation duringfollow-up(n = 318)	P-value	Persistent atrialfibrillation duringfollow-up(n = 229)	P-value
Unadjusted	0 Reference group	0.27	0.4	0 Reference group	1.18	0.0001	1.82	<0.0001
Adjusted*		0.05	0.8		–	–	–	–
Adjusted**		–	–	–	1.02	0.0001	1.62	<0.0001

Analysis by linear regression, using separate models for all patients and for patients with no atrial fibrillation at baseline.

* Adjustment for gender, age, race, heart rate, creatinine, smoking, diabetes mellitus, left ventricular hypertrophy with strain, history of stroke/TIA, and mean systolic blood pressure during follow-up (visits 6-15)

**Adjustment for age, race, heart rate, creatinine, smoking, left ventricular hypertrophy with strain, treatment, body mass index, systolic blood pressure at baseline, and mean systolic blood pressure during follow-up (visits 6–15)