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- Title
Blood Pressure Control and Risk of Incident Atrial Fibrillation.
- Authors
Thomas, M. C.; Dublin, S.; Kaplan, R. C.; Glazer, N. L.; Lumley, T.; Longstreth Jr., W. T.; Smith, N. L.; Psaty, B. M.; Siscovick, D. S.; Heckbert, S. R.
- 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 ≥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 ≥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.
- Subjects
UNITED States; ATRIAL fibrillation risk factors; DIASTOLE (Cardiac cycle); PATIENTS; HYPERTENSION; CARDIAC contraction; ARRHYTHMIA
- Publication
American Journal of Hypertension, 2008, Vol 21, Issue 10, p1111
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1038/ajh.2008.248