Key result
Higher systolic BP time in target range linked to ~31% lower incident AF risk.
Why the study?
Higher systolic blood pressure time in target range (TTR) is associated with reduced cardiovascular disease risk, but evidence from large-scale prospective cohort studies linking long-term systolic blood pressure TTR to new-onset atrial fibrillation remained limited.
Does a higher percentage of systolic blood pressure time in target range (<140 mmHg) reduce the risk of incident atrial fibrillation in middle-aged and older adults?
Cohort (n=46,597)
Does a higher percentage of systolic blood pressure time in target range (<140 mmHg) reduce the risk of incident atrial fibrillation in middle-aged and older adults?
Long-term maintenance of systolic blood pressure within the target range (<140 mmHg) is linearly associated with a significantly lower risk of developing new-onset atrial fibrillation.
Background Systolic blood pressure time in target range (TTR) indicates the average value, exposure time, and variability in blood pressure over time. Previous studies have shown that a higher percentage of systolic blood pressure TTR was associated with a decreased risk of cardiovascular disease. However, evidence from large-scale prospective cohort studies on the relationship between long-term systolic blood pressure TTR and new-onset atrial fibrillation remains limited. Objective This study aims to explore the relationship between the long - term systolic blood pressure TTR and the risk of new - onset atrial fibrillation. Methods The study subjects were from the UK Biobank. A total of 46,597 participants (mean age: 55.70±7.63 years, 47.63% male) were included. Blood pressure measurements were taken at baseline (2006–2010), the first follow - up (2012–2013), and the second follow - up (2014 and later). Individuals with at least two systolic blood pressure measurement records were included in this study. The target systolic blood pressure range was set at <140 mmHg. Systolic blood pressure TTR was calculated by the Rosendaal linear interpolation method. The relationship between the systolic blood pressure TTR and atrial fibrillation was evaluated through Cox proportional hazards regression model and restricted cubic spline. Results During the follow - up period, a total of 1,324 atrial fibrillation events were documented. After adjusting for potential confounders, compared with the lowest systolic blood pressure TTR group (0%–25%), the risk of atrial fibrillation occurrence in the highest group (75%–100%) was reduced by 31% (HR = 0.69, 95% CI: 0.60–0.79). A 10% increase in systolic blood pressure TTR was independently associated with a 4% lower risk of incident atrial fibrillation (HR = 0.96, 95% CI: 0.95–0.98). Restricted cubic spline analysis showed a linear negative correlation between the systolic blood pressure TTR and new - onset atrial fibrillation. Subgroup analyses showed that this association was consistent across all sub - groups (all interaction P > 0.05). Conclusion A greater percentage of systolic blood pressure TTR was associated with a lower risk of atrial fibrillation. These findings support long-term maintenance of systolic blood pressure within the recommended range as an important strategy for the primary prevention of atrial fibrillation.
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Wang et al. (2026) conducted a cohort in New-onset atrial fibrillation (n=46,597). Highest systolic blood pressure time in target range (<140 mmHg; 75%–100%) vs. Lowest systolic blood pressure time in target range (0%–25%) was evaluated on Incident atrial fibrillation (HR 0.69, 95% CI 0.60-0.79). High systolic BP time in target range (75%–100% vs 0%–25% at <140 mmHg) was associated with a 31% lower risk of incident atrial fibrillation (HR 0.69; 95% CI 0.60–0.79).
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