Key result
Higher systolic blood pressure was strongly associated with an increased risk of incident atrial fibrillation in women.
Why the study?
Does elevated systolic and diastolic blood pressure increase the risk of incident atrial fibrillation in initially healthy women?
Cohort (n=34,221)
Does elevated systolic and diastolic blood pressure increase the risk of incident atrial fibrillation in initially healthy women?
Systolic blood pressure, even within the nonhypertensive range, is strongly and independently associated with an increased risk of incident atrial fibrillation in initially healthy women.
Answers are grounded in this paper and cite their sources.
May warrant closer BP monitoring in women; leaves open whether SBP lowering prevents incident AF.
BACKGROUND: The influence of systolic and diastolic blood pressure (BP) on incident atrial fibrillation (AF) is not well studied among initially healthy, middle-aged women. METHODS AND RESULTS: A total of 34,221 women participating in the Women's Health Study were prospectively followed up for incident AF. The risk of AF across categories of systolic and diastolic BP was compared by use of Cox proportional-hazards models. During 12.4 years of follow-up, 644 incident AF events occurred. Using BP measurements at baseline, we discovered that the long-term risk of AF was significantly increased across categories of systolic and diastolic BP. Multivariable-adjusted hazard ratios for systolic BP categories (<120, 120 to 129, 130 to 139, 140 to 159, and > or =160 mm Hg) were 1.0, 1.00 (95% CI, 0.78 to 1.28), 1.28 (95% CI, 1.00 to 1.63), 1.56 (95% CI, 1.22 to 2.01), and 2.74 (95% CI, 1.77 to 4.22) (P for trend <0.0001). Adjusted hazard ratios across baseline diastolic BP categories (<65, 65 to 74, 75 to 84, 85 to 89, 90 to 94, and > or =95 mm Hg) were 1.0, 1.17 (95% CI, 0.81 to 1.69), 1.18 (95% CI, 0.84 to 1.65), 1.53 (95% CI, 1.05 to 2.23), 1.35 (95% CI, 0.82 to 2.22), and 2.15 (95% CI, 1.21 to 3.84) (P for trend=0.004). When BP changes over time were accounted for in updated models, multivariable-adjusted hazard ratios were 1.0, 1.14 (95% CI, 0.89 to 1.46), 1.37 (95% CI, 1.07 to 1.76), 1.71 (95% CI, 1.33 to 2.21), and 2.21 (95% CI, 1.45 to 3.36) (P for trend <0.0001) for systolic BP categories and 1.0, 1.12 (95% CI, 0.82 to 1.52), 1.13 (95% CI, 0.83 to 1.52), 1.30 (95% CI, 0.89 to 1.88), 1.50 (95% CI, 1.01 to 1.88), and 1.54 (95% CI, 0.75 to 3.14) (P for trend=0.026) for diastolic BP categories. CONCLUSIONS: In this large cohort of initially healthy women, BP was strongly associated with incident AF, and systolic BP was a better predictor than diastolic BP. Systolic BP levels within the nonhypertensive range were independently associated with incident AF even after BP changes over time were taken into account.
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Conen et al. (2009) conducted a cohort in Incident atrial fibrillation (n=34,221). Systolic and diastolic blood pressure vs. Baseline systolic BP <120 mm Hg and diastolic BP <65 mm Hg was evaluated on Incident atrial fibrillation (HR 2.74, 95% CI 1.77 to 4.22, p=<0.0001). Higher systolic blood pressure was strongly associated with an increased risk of incident atrial fibrillation in women.
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