Key result
Blood pressure <120/<80 mm Hg increased incident atrial fibrillation risk in non-octogenarians compared to 120-129/<80 mm Hg (HR 1.15; 95% CI 1.03-1.28; p<0.001).
Why the study?
It is uncertain whether maintaining optimal blood pressure levels can prevent atrial fibrillation in the general elderly population.
What is the ideal blood pressure threshold for the prevention of incident atrial fibrillation in the elderly general population?
Cohort (n=115,866)
What is the ideal blood pressure threshold for the prevention of incident atrial fibrillation in the elderly general population?
Effect estimate: HR 1.15 (95% CI 1.03-1.28)
p-value: p=<0.001
The optimal blood pressure for minimizing incident atrial fibrillation risk follows a U-shaped curve and is higher in octogenarians (130-139/80-89 mm Hg) compared to non-octogenarians (120-129/<80 mm Hg).
Challenges intensive BP lowering below 120/80 mm Hg for AF prevention; leaves open age-specific targets in prospective trials.
Intensive blood pressure (BP) lowering in patients with hypertension at increased risk of cardiovascular disease has been associated with a lowered risk of incident atrial fibrillation (AF). It is uncertain whether maintaining the optimal BP levels can prevent AF in the general elderly population. We included 115,866 participants without AF in the Korea National Health Insurance Service-Senior (≥60 years) cohort from 2002 to 2013. We compared the influence of BP on the occurrence of new-onset AF between octogenarians (≥80 years) and non-octogenarians (<80 years) subjects. With up to 6.7 ± 1.7 years of follow-up, 4393 incident AF cases occurred. After multivariable adjustment for potentially confounding clinical covariates, the risk of AF in non-octogenarians was significantly higher in subjects with BP levels of <120/<80 and ≥140/90 mm Hg, with hazard ratios of 1.15 (95% confidence interval (CI), 1.03–1.28; p < 0.001) and 1.14 (95% CI, 1.04–1.26; p < 0.001), compared to the optimal BP levels (120–129/<80 mm Hg). In octogenarians, the optimal BP range was 130–139/80–89 mm Hg, higher than in non-octogenarians. A U-shaped relationship for the development of incident AF was evident in non-octogenarians, and BP levels of 120–129/<80 mm Hg were associated the lowest risk of incident AF. Compared to non-octogenarians, the lowest risk of AF was associated with higher BP levels of 130–139/80–89 mm Hg amongst octogenarians.
No takes yet. Share an insight, caveat, or question.
Park et al. (2020) conducted a cohort in Atrial fibrillation (n=115,866). Blood pressure <120/<80 mm Hg vs. Blood pressure 120-129/<80 mm Hg was evaluated on Incident atrial fibrillation (HR 1.15, 95% CI 1.03-1.28, p=<0.001). Blood pressure <120/<80 mm Hg increased incident atrial fibrillation risk in non-octogenarians compared to 120-129/<80 mm Hg (HR 1.15; 95% CI 1.03-1.28; p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: