Anxiety-related blood pressure variability in patients with atrial fibrillation after cardioembolic stroke

Abstract

Aim. To investigate whether of anxiety-related blood pressure (BP) variability can be corrected in patients with atrial fibrillation (AF) who have experienced cardioembolic stroke (CES). Subjects and methods. The investigation enrolled 125 patients (mean age, 68.5±5.7 years) with AF, who had experienced CES. The patients were randomized into 2 groups by the envelope technique: 1) 63 patients received antihypertensive drugs and an anxiolytic (adaptol) (a study group); 2) 62 patients had antihypertensive drugs only (a comparison group). Effectiveness was evaluated 2 and 6 weeks later from the time course of changes in BP readings obtained by 24-hour Holter monitoring in relation to reactive anxiety (RA) and personal anxiety (PA) scores. The latter were determined using the Spielberger-Hanin Anxiety Self-Esteem scale. Results. The patients with AF who had experienced CES were noted to have high BP variability associated with increased RA and PA scores. Group 1 showed statistically significant improvements in RA and PA 2 and 6 weeks after the start of treatment. The efficiency of anti-anxiety therapy (adaptol at a dose of 500 to 1500 mg/day) in combination with antihypertensive drugs is confirmed by the normalized circadian BP profile. Conclusion. The incorporation of an anxiolytic into pharmacotherapy regimens could improve BP, namely, to reduce and stabilize its circadian profile.

Keywords

• atrial fibrillation
• anxiety
• cardioembolic stroke
• variability of circadian blood pressure profile
• adaptol