February 20, 2007JAMA
Pulse Pressure and Risk of New-Onset Atrial Fibrillation
Why the study?
Does increased pulse pressure increase the risk of incident atrial fibrillation in adults initially free from the disease?
Population
5,331 community-based participants aged 35 years and older and initially free from atrial fibrillation from…
Design
Cohort
Follow-up
median 12 years
Authors
Discussion
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Implication
May aid AF risk stratification in primary prevention cohorts; extends observational links between arterial stiffness and arrhythmia but requires causal confirmation.
Key Points
- This study aims to explore the relationship between pulse pressure and the development of incident atrial fibrillation.
- Prospective community-based observational cohort study with 5331 participants aged 35 and older.
- Assessment of pulse pressure and follow-up for incident atrial fibrillation over a median of 12 years.
- Adjustment for various clinical risk factors including body mass index, smoking, and hypertension treatment.
- Atrial fibrillation developed in 698 participants (13.1%), with a cumulative 20-year incidence rate of 23.3% for pulse pressure >61 mm Hg.
- Pulse pressure was associated with a 26% increased risk for atrial fibrillation per 20 mm Hg increment (HR, 1.26; 95% CI, 1.12-1.43; P<.001).
- The relationship remained significant even after adjusting for echocardiographic parameters (adjusted HR, 1.23; 95% CI, 1.09-1.39; P = .001).
Structured PICO
Does increased pulse pressure increase the risk of incident atrial fibrillation in adults initially free from the disease?
P
Population
5,331 community-based participants aged 35 years and older and initially free from atrial fibrillation (median age 57 years, 55% women) from the Framingham Heart Study in Framingham, Mass.
I
Intervention
Increased pulse pressure (evaluated per 20-mm Hg increment)
O
Outcome
Incident atrial fibrillationhard clinical
Increased pulse pressure is an independent risk factor for incident atrial fibrillation in a community-based population, suggesting aortic stiffness contributes to AF pathogenesis.
Cite This Study
Mitchell et al. (2007) studied this question.