Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2013;66:458-63 - Vol. 66 Num.06 DOI: 10.1016/j.rec.2012.11.011

Nighttime Ambulatory Blood Pressure is Associated With Atrial Remodelling and Neurohormonal Activation in Patients With Idiopathic Atrial Fibrillation

Mónica Doménech a, Antonio Berruezo b, Irma Molina b, Lluis Mont b, Antonio Coca a,

a Unidad de Hipertensión y Riesgo Vascular, Servicio de Medicina Interna, Instituto de Medicina y Dermatología, Hospital Clínic (IDIBAPS), Universidad de Barcelona, Barcelona, Spain
b Unidad de Arritmias, Servicio de Cardiología, Instituto del Tórax, Hospital Clínic (IDIBAPS), Universidad de Barcelona, Barcelona, Spain

Refers to

Relationship Between Nighttime Blood Pressure, the Renin-angiotensin System, and Melatonin
Alberto Dominguez-Rodriguez, Pedro Abreu-Gonzalez
Rev Esp Cardiol. 2013;66:831-2
Full text - PDF

Keywords

Atrial fibrillation. Atrial natriuretic peptide. Brain natriuretic peptide. Nocturnal blood pressure.

Abstract

Introduction and objectives

Hypertension is a risk factor for atrial fibrillation. Activation of the renin-angiotensin-system seems to be involved in atrial enlargement, with release of atrial and brain natriuretic peptides. The aim of this study was to evaluate the relationship between ambulatory blood pressure and levels of natriuretic peptides, with left atrial size in normotensives with idiopathic atrial fibrillation.

Methods

This was a cross-sectional study in patients with idiopathic atrial fibrillation. The following measurements were recorded during the course of the study: office and 24-h ambulatory blood pressure, atrial and brain natriuretic peptides, plasma renin, aldosterone, and angiotensin–converting enzyme.

Results

Forty-eight patients (mean age 55 [10] years; 70.6% male) were included in the study. Mean office sitting blood pressure values were 132.49 (14.9)/80.96 (9.2) mmHg. Mean 24-h ambulatory systolic and diastolic blood pressure values were 121.10 (8.3)/72.11 (6.8) mmHg (daytime, 126.8 [9.7]/77.58 [7.9] mmHg; nighttime, 114.56 [11.6]/68.6 [8.8] mmHg). A clear trend towards increased left atrial size with higher ambulatory blood pressure values was noted, which was statistically significant for nighttime values (r=0.34; P=.020 for systolic and r=0.51; p=.0001 for diastolic). A significant correlation between atrial natriuretic peptide and nighttime systolic (r=0.297; P=.047) and diastolic (r=0.312; P=.037) blood pressure was observed. Significant correlations were also observed between left atrial size and atrial natriuretic peptide levels (r=0.577; p<.0001) and brain natriuretic peptide levels (r=0.379; P=.012).

Conclusions

Nighttime blood pressure is associated with left atrial size and the release of natriuretic peptides in normotensive patients with idiopathic atrial fibrillation.

1885-5857/© 2013 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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