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Comparative Study
. 2008 Oct;21(10):1111-6.
doi: 10.1038/ajh.2008.248. Epub 2008 Aug 28.

Blood pressure control and risk of incident atrial fibrillation

M C Thomas  1 , S Dublin, R C Kaplan, N L Glazer, T Lumley, W T Longstreth Jr, N L Smith, B M Psaty, D S Siscovick, S R Heckbert
Affiliations
Comparative Study

Blood pressure control and risk of incident atrial fibrillation

M C Thomas et al. Am J Hypertens. 2008 Oct.

Abstract

Background: Atrial fibrillation (AF) is a common arrhythmia that affects more than 2 million people in the United States. We sought to determine whether the risk of incident AF among patients treated for hypertension differs by the degree of blood pressure control.

Methods: A population-based, case-control study of 433 patients with verified incident AF and 899 controls was conducted to investigate the relationship between average achieved systolic (SBP) and diastolic (DBP) blood pressure and risk of AF. All patients were members of an integrated health-care delivery system and were pharmacologically treated for hypertension. Medical records were reviewed to confirm the diagnosis of new onset AF and to collect information on medical conditions, health behaviors, and measured blood pressures. Average achieved SBP and DBP were calculated from the three most recent outpatient blood pressure measurements.

Results: Compared with the reference level of 120-129 mm Hg, for categories of average achieved SBP of <120, 130-139, 140-149, 150-159, 160-169, and > or =170 mm Hg, the odds ratios (ORs; 95% confidence interval (CI)) for incident AF were 1.99 (1.10, 3.62), 1.19 (0.78, 1.81), 1.40 (0.93, 2.09), 2.02 (1.30, 3.15), 2.27 (1.31, 3.93), and 1.84 (0.89, 3.80), respectively. Based on the population attributable fraction, we estimated that, among patients with treated hypertension, 17.2% (95% CI 4.3%, 28.3%) of incident AF was attributable to an average achieved SBP > or =140 mm Hg.

Conclusion: Among patients treated for hypertension, uncontrolled elevated SBP and SBP <120 mm Hg were associated with an increased risk of incident AF.

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Figures

Figure 1
Figure 1
Odds ratios of incident atrial fibrillation associated with average achieved systolic blood pressure Adjusted for age (continuous), sex, and index year. P — values vs. SBP = 120-129 mm Hg: SBP = <120 mm Hg, p = .02; 130-139 mm Hg, p = .42; 140-149 mm Hg, p = .11; 150-159 mm Hg, p < .01; 160-169 mm Hg, p < .01; ≥170 mm Hg, p = .10
Figure 2
Figure 2
Odds ratios of incident atrial fibrillation associated with average achieved diastolic blood pressure Adjusted for age (continuous), sex, and index year. P — values vs. DBP = 65-69 mm Hg: DBP = <65 mm Hg, p = .46; 70-74 mm Hg, p = .90; 75-79 mm Hg, p = .76; 80-84 mm Hg, p = .53; 85-89 mm Hg, p = .66; 90-95 mm Hg, p = .38; ≥95 mm Hg, p = .03
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References

    1. Feinberg WM, Blackshear JL, Laupacis A, Kronmal R, Hart RG. Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications. Arch Intern Med. 1995;155(5):469–73. - PubMed
    1. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22(8):983–8. - PubMed
    1. Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98(10):946–52. - PubMed
    1. Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol. 1998;82(8A):2N–9N. - PubMed
    1. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285(18):2370–5. - PubMed

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