Key result
The presence of both hypertension and proteinuria was associated with a 98% increased risk of incident atrial fibrillation compared to controls (HR 1.98; 95% CI 1.62-2.43; P<0.001).
Why the study?
The excess risk of atrial fibrillation related to proteinuria associated with hypertension has not been well elucidated.
Does the presence of hypertension and/or proteinuria increase the risk of incident atrial fibrillation in an elderly population?
Cohort (n=211,346)
Yes
Does the presence of hypertension and/or proteinuria increase the risk of incident atrial fibrillation in an elderly population?
The presence of both hypertension and proteinuria significantly increases the risk of incident atrial fibrillation in elderly patients, suggesting proteinuria is a useful predictor for AF development.
Proteinuria with hypertension was associated with AF incidence; leaves open whether modifying proteinuria status alters risk.
Objective: The excess risk of atrial fibrillation in relation to the presence of proteinuria associated with hypertension has not been well elucidated. We aimed to determine the effect of hypertension and/or proteinuria on the incidence of atrial fibrillation. Second, we evaluated whether the associations with temporal changes in proteinuria status on the incidence of atrial fibrillation. Methods and results: A total of 85 434 participants with hypertension and 125 912 participants without hypertension with age at least 60 years from the Korea National Health Insurance Service-Senior cohort were included. Amongst controls (participants without proteinuria and hypertension), hypertension only, proteinuria only, and hypertension with proteinuria groups, the adjusted incidences of atrial fibrillation were 0.51, 0.69. 0.78 and 0.99 per 100 person-years, respectively after inverse probability of treatment weighting. Compared with controls, the weighted risks of atrial fibrillation in the hypertension only, proteinuria only and hypertension with proteinuria groups were increased by 37% (hazard ratio 1.37, 95% confidence interval, CI 1.30–1.44, P = 0.001), 55% (hazard ratio 1.55, 95% CI 1.28–1.88, P < 0.001), and 98% (hazard ratio 1.98, 95% CI 1.62–2.43, P < 0.001), respectively. Populations who had proteinuria in the first examination had an increased risk of atrial fibrillation even in the group whereby the proteinuria was resolved on the second examination (hazard ratio 1.36, 95% CI 1.12–2.31, P < 0.001). The presence of proteinuria in first and second analysis had the highest risk of incident atrial fibrillation (hazard ratio 1.61, 95% CI 1.12–2.31). Conclusion: In conclusion, hypertension and/or proteinuria were associated with increased risk of atrial fibrillation, with the greatest risks when both are present. Proteinuria could be a useful factor for predicting atrial fibrillation development.
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Park et al. (2021) conducted a cohort in Hypertension and proteinuria (n=211,346). Hypertension and proteinuria vs. Participants without proteinuria and hypertension was evaluated on Incident atrial fibrillation (HR 1.98, 95% CI 1.62-2.43, p=<0.001). The presence of both hypertension and proteinuria was associated with a 98% increased risk of incident atrial fibrillation compared to controls (HR 1.98; 95% CI 1.62-2.43; P<0.001).
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