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Effect of Intensive Blood Pressure Lowering on Incident Atrial Fibrillation and P-Wave Indices in the ACCORD Blood Pressure Trial

, : Effect of Intensive Blood Pressure Lowering on Incident Atrial Fibrillation and P-Wave Indices in the ACCORD Blood Pressure Trial. American Journal of Hypertension (): -

There are no proven strategies to prevent atrial fibrillation (AF) in patients with type 2 diabetes (T2DM). We compared standard blood pressure (BP) lowering vs. intensive BP lowering in reducing incidence of AF or P-wave indices (PWI-ECG markers of left atrial abnormality that are considered intermediate phenotypes of AF) in patients with T2DM. We analyzed data from the ACCORD BP trial-a randomized controlled nonblinded trial (2001-2009) which randomized patients with T2DM and systolic BP (SBP) 130-180mm Hg on ≤3 antihypertensive medications aged 40-79 years with cardiovascular disease (CVD) or aged 55-79 years with subclinical CVD or ≥2 CVD risk factors to standard BP lowering (SBP <140mm Hg) vs. intensive BP lowering (SBP <120mm Hg). The primary outcome was a composite of incident AF and PWI. Data from 3,087 participants (mean age, 62.2 years; women, 48.2%; non-White, 39.2%) were analyzed. During a mean follow-up of 4.4 years, the primary outcome occurred in 1,063 participants (incidence rate, 84.5 per 1,000 person-years in the standard-therapy group vs. 73.9 per 1,000 person-years in the intensive-therapy group). The adjusted hazard ratios (95% confidence intervals) of intensive-therapy group for the primary outcome and for incident PWI alone were 0.87 (0.77-0.98), P = 0.02 and 0.87 (0.76-0.98), P = 0.02, respectively. The effect of intensive therapy on the incidence of AF alone did not reach statistical significance. In patients with T2DM, intensive BP lowering reduces the incidence of the composite outcome of AF and PWI, suggesting a potential benefit from stringent BP control in patients with T2DM.clinical trials registrationTrial Number NCT00000620.


PMID: 26476086

DOI: 10.1093/ajh/hpv172

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Hensler, D.; Sillanpaa, P.J.; Schoettle, P.B., 2014: Medial patellofemoral ligament: anatomy, injury and treatment in the adolescent knee. Traumatic and nontraumatic patellofemoral instability (PFI) in children and adolescents is a complex problem. It is determined by a large number of mechanical and pathomorphologic conditions, mainly seen in nontraumatic dislocations. Although cons...

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Sternbach, G.; Osler, W., 1983: William Osler: narcotic-induced pulmonary edema. William Osler described the first reported case of narcotic-induced pulmonary edema in 1880. The description is that of autopsy findings of a patient who died of narcotic poisoning. Since that time, noncardiogenic pulmonary edema has come to be kn...

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Qadri, S.M.; Wende, R.D., 1977: A single-bottle blood culture system: evaluation and comparison with two other systems. A commercially available single-bottle blood culture system was evaluated at Ben Taub General Hospital, a Harris County District Hospital. Blood cultures from 1010 patients were examined with the Lederle Diagnostics one-bottle blood culture medium...

Montedoro, G.B.rtuccioli, M.P.truccioli, G., 1975: Effects of the treatments by enzymatic preparations and tannin phenolics absorbent agents in extracting the olive oil by single pressure process on the oil yield, on the analytical characteristics of the oils and of the wastewaters. Rivista italiana delle sostanze grasse: 52 (8) 255-265

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