To assess a relationship between arterial stiffness and health-realted quality of life (QoL) in hypertensive patients with atrial fibrillation (AF).
Material and methods
Fifty five hypertensive pts (40% male) aged 66 (62; 73) years with recurrent AF were treated with metoprolol (n=31) or diltiazem (n=24). All patients underwent clinical and echocardiographic examination, applanation tonometry by Sphygmocor and completed SF36v2 questionnaire before and 3 months after treatment.
Both diltiazem and metorpolol reduced brachial blood pressure as well as systolic and diastolic central blood pressure and pulse wave velocity (PWV). However, decrease in amplification index in the diltiazem arm was less than in the metoprolol arm. Despite comparable heart rate reduction, diltiazem decreased central augmentation index while metoprolol increased it. Over 3-month follow-up, AF recurrences were documented in 36 (65%) patients. There were no significant differences in changes of Physical Component Summary (PCS) and Mental Component Summary (MCS) between patients with and without recurrent AF. Logistic regression analysis showed significant negative association between improvement of PCS and PWV (p=0,04) and between improvement of MCS and baseline MCS ( p<0,0001). Age [odds ratio (OR) 1,07; 95% CI 1,01-1,13; p=0,02] and PWV [OR 1,46; 95% CI 1,18-1,80; p=0,0004] were associated with increased risk of AF recurrence.
Lower baseline PWV was associated with improvement of PCS irrespective of AF recurrences in patients with arterial hypertension. Pulse wave velocity and age were an independent predictors of arrhythmia recurrence in hypertensive patients with short-term history of AF.
Atrial fibrillation, arterial rigidity, HRQoL.