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Exploring the link between blood pressure variability and atrial fibrillation: current insights and future directions

Journal of Human Hypertension volume 38, pages 583–594 (2024)Cite this article

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Abstract

Atrial fibrillation (AF) is the most common heart rhythm disorder, especially in people over the age of 50, which affects more than 40 million people worldwide. Many studies have highlighted the association between hypertension with the development of AF. Blood pressure variability (BPV) is a dynamic size obtained by recording blood pressure oscillations using specific readings and at specific time intervals. A multitude of internal and external factors shape BPV while at the same time constituting a common pathogenetic pathway with the development of AF. Until recently, BPV has been applied exclusively in preclinical and clinical studies, without significant implications in clinical practice. Indeed, even from the research side, the determination of BPV is limited to patients without AF due to doubts about the accuracy of its measurement methods in patients with AF. In this review, we present the current evidence on common pathogenic pathways between BPV and AF, the reliability of quantification of BPV in patients with AF, the prognostic role of BPV in these patients, and discuss the future clinical implications of BPV in patients with AF.

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Fig. 1: Types of blood pressure variability, measurement techniques and main shaping factors.
Fig. 2: Schematic diagram highlighting the bidirectional pathogenetic link of blood pressure variability and atrial fibrillation.

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All data supporting reported results can be found on PubMed. The details are provided in References.

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Authors and Affiliations

  1. Department of Cardiology, Royal Brompton and Harefield Hospitals, Guy’s & St Thomas’ NHS Foundation Trust, London, UK

    Konstantinos Konstantinou & Vasileios Panoulas

  2. First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece

    Konstantinos Konstantinou, Anastasios Apostolos, Dimitrios Tsiachris, Kyriakos Dimitriadis, Panteleimon E. Papakonstantinou & Konstantinos Tsioufis

  3. Second Department of Ophthalmology, Medical School, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece

    Konstantinos Pappelis

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Contributions

Conceptualization: KK, CT. Methodology: KK, AA, VP, DT, KD. Data Collection: KK, AA, KP, PP, DT. Writing—Original Draft Preparation: KK, AA, PP. Writing—Review and Editing: KK, KP, CT, VP, KD. Supervision: CT.

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Correspondence to Konstantinos Konstantinou.

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Konstantinou, K., Apostolos, A., Tsiachris, D. et al. Exploring the link between blood pressure variability and atrial fibrillation: current insights and future directions. J Hum Hypertens 38, 583–594 (2024). https://doi.org/10.1038/s41371-024-00936-z

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