Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
To the Editor.—In the study by the SPAF III Writing Committee for the Stroke Prevention in Atrial Fibrillation Investigators,1 the selection of "systolic blood pressure greater than 160 mm Hg" as 1 of the 4 prespecified thromboembolic risk factors while enrolling patients with hypertension requiring drug treatment is confusing. In general, arterial blood pressure (BP) follows a circadian rhythm.2 In addition, the monitoring of BP was intermittent in the study,1 and so episodes of systolic hypertension (as defined by the authors) would be missed.
Cheung R. Patients With Atrial Fibrillation at Low Risk of Stroke. JAMA. 1998;280(10):882-883. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-10-jac80015