Restoring Sinus Rhythm Results in Blood Pressure Reduction in Patients with Persistent Atrial Fibrillation and a History of Hypertension

Effects of Rhythm Control on Blood Pressure. Introduction: The long‐term effects of atrial fibrillation (AF) on blood pressure (BP) in patients with hypertension (HTN) remain unclear. We hypothesized that restoration of normal sinus rhythm (NSR) results in a decrease in BP despite the expected increase in cardiac output. Methods and Results: Twenty‐four‐hour BP measurements were obtained during AF, and on Day 1 and Day 30 post‐successful cardioversion in 18 patients with AF and HTN (cardioversion group), and another 22 patients with AF and HTN with no immediate plans for cardioversion (control group). Except for the duration of AF, the clinical characteristics and use of medications were similar between the groups. In the cardioversion group, a significant decrease in diastolic blood pressure (DBP) and mean blood pressure (MBP) were noted on Day 1 post‐cardioversion with no significant change in systolic blood pressure (SBP): 117/74/88 ± 13/9/9 mmHg during AF and 116/70/85 ± 13/9/10 mmHg during Day 1 post‐cardioversion (P = 0.68;