Blood pressure control and risk of incident atrial fibrillation

M. C. Thomas, S. Dublin, Robert C. Kaplan, N. L. Glazer, T. Lumley, W. T. Longstreth, N. L. Smith, B. M. Psaty, D. S. Siscovick, S. R. Heckbert

Research output: Contribution to journalArticle

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Abstract

Background: Atrial fibrillation (AF) is a common arrhythmia that affects more than 2 million people in the United States. We sought to determine whether the risk of incident AF among patients treated for hypertension differs by the degree of blood pressure control. Methods: A population-based, case-control study of 433 patients with verified incident AF and 899 controls was conducted to investigate the relationship between average achieved systolic (SBP) and diastolic (DBP) blood pressure and risk of AF. All patients were members of an integrated health-care delivery system and were pharmacologically treated for hypertension. Medical records were reviewed to confirm the diagnosis of new onset AF and to collect information on medical conditions, health behaviors, and measured blood pressures. Average achieved SBP and DBP were calculated from the three most recent outpatient blood pressure measurements. Results: Compared with the reference level of 120-129 mm Hg, for categories of average achieved SBP of <120, 130-139, 140-149, 150-159, 160-169, and ≥170 mm Hg, the odds ratios (ORs; 95% confidence interval (CI)) for incident AF were 1.99 (1.10, 3.62), 1.19 (0.78, 1.81), 1.40 (0.93, 2.09), 2.02 (1.30, 3.15), 2.27 (1.31, 3.93), and 1.84 (0.89, 3.80), respectively. Based on the population attributable fraction, we estimated that, among patients with treated hypertension, 17.2% (95% CI 4.3%, 28.3%) of incident AF was attributable to an average achieved SBP ≥140 mm Hg. Conclusion: Among patients treated for hypertension, uncontrolled elevated SBP and SBP <120 mm Hg were associated with an increased risk of incident AF.

Original languageEnglish (US)
Pages (from-to)1111-1116
Number of pages6
JournalAmerican Journal of Hypertension
Volume21
Issue number10
DOIs
StatePublished - Oct 2008

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Atrial Fibrillation
Blood Pressure
Hypertension
Integrated Delivery of Health Care
Confidence Intervals
Health Behavior
Population
Medical Records
Case-Control Studies
Cardiac Arrhythmias
Outpatients
Odds Ratio

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Thomas, M. C., Dublin, S., Kaplan, R. C., Glazer, N. L., Lumley, T., Longstreth, W. T., ... Heckbert, S. R. (2008). Blood pressure control and risk of incident atrial fibrillation. American Journal of Hypertension, 21(10), 1111-1116. https://doi.org/10.1038/ajh.2008.248

Blood pressure control and risk of incident atrial fibrillation. / Thomas, M. C.; Dublin, S.; Kaplan, Robert C.; Glazer, N. L.; Lumley, T.; Longstreth, W. T.; Smith, N. L.; Psaty, B. M.; Siscovick, D. S.; Heckbert, S. R.

In: American Journal of Hypertension, Vol. 21, No. 10, 10.2008, p. 1111-1116.

Research output: Contribution to journalArticle

Thomas, MC, Dublin, S, Kaplan, RC, Glazer, NL, Lumley, T, Longstreth, WT, Smith, NL, Psaty, BM, Siscovick, DS & Heckbert, SR 2008, 'Blood pressure control and risk of incident atrial fibrillation', American Journal of Hypertension, vol. 21, no. 10, pp. 1111-1116. https://doi.org/10.1038/ajh.2008.248
Thomas, M. C. ; Dublin, S. ; Kaplan, Robert C. ; Glazer, N. L. ; Lumley, T. ; Longstreth, W. T. ; Smith, N. L. ; Psaty, B. M. ; Siscovick, D. S. ; Heckbert, S. R. / Blood pressure control and risk of incident atrial fibrillation. In: American Journal of Hypertension. 2008 ; Vol. 21, No. 10. pp. 1111-1116.
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abstract = "Background: Atrial fibrillation (AF) is a common arrhythmia that affects more than 2 million people in the United States. We sought to determine whether the risk of incident AF among patients treated for hypertension differs by the degree of blood pressure control. Methods: A population-based, case-control study of 433 patients with verified incident AF and 899 controls was conducted to investigate the relationship between average achieved systolic (SBP) and diastolic (DBP) blood pressure and risk of AF. All patients were members of an integrated health-care delivery system and were pharmacologically treated for hypertension. Medical records were reviewed to confirm the diagnosis of new onset AF and to collect information on medical conditions, health behaviors, and measured blood pressures. Average achieved SBP and DBP were calculated from the three most recent outpatient blood pressure measurements. Results: Compared with the reference level of 120-129 mm Hg, for categories of average achieved SBP of <120, 130-139, 140-149, 150-159, 160-169, and ≥170 mm Hg, the odds ratios (ORs; 95{\%} confidence interval (CI)) for incident AF were 1.99 (1.10, 3.62), 1.19 (0.78, 1.81), 1.40 (0.93, 2.09), 2.02 (1.30, 3.15), 2.27 (1.31, 3.93), and 1.84 (0.89, 3.80), respectively. Based on the population attributable fraction, we estimated that, among patients with treated hypertension, 17.2{\%} (95{\%} CI 4.3{\%}, 28.3{\%}) of incident AF was attributable to an average achieved SBP ≥140 mm Hg. Conclusion: Among patients treated for hypertension, uncontrolled elevated SBP and SBP <120 mm Hg were associated with an increased risk of incident AF.",
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AU - Dublin, S.

AU - Kaplan, Robert C.

AU - Glazer, N. L.

AU - Lumley, T.

AU - Longstreth, W. T.

AU - Smith, N. L.

AU - Psaty, B. M.

AU - Siscovick, D. S.

AU - Heckbert, S. R.

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N2 - Background: Atrial fibrillation (AF) is a common arrhythmia that affects more than 2 million people in the United States. We sought to determine whether the risk of incident AF among patients treated for hypertension differs by the degree of blood pressure control. Methods: A population-based, case-control study of 433 patients with verified incident AF and 899 controls was conducted to investigate the relationship between average achieved systolic (SBP) and diastolic (DBP) blood pressure and risk of AF. All patients were members of an integrated health-care delivery system and were pharmacologically treated for hypertension. Medical records were reviewed to confirm the diagnosis of new onset AF and to collect information on medical conditions, health behaviors, and measured blood pressures. Average achieved SBP and DBP were calculated from the three most recent outpatient blood pressure measurements. Results: Compared with the reference level of 120-129 mm Hg, for categories of average achieved SBP of <120, 130-139, 140-149, 150-159, 160-169, and ≥170 mm Hg, the odds ratios (ORs; 95% confidence interval (CI)) for incident AF were 1.99 (1.10, 3.62), 1.19 (0.78, 1.81), 1.40 (0.93, 2.09), 2.02 (1.30, 3.15), 2.27 (1.31, 3.93), and 1.84 (0.89, 3.80), respectively. Based on the population attributable fraction, we estimated that, among patients with treated hypertension, 17.2% (95% CI 4.3%, 28.3%) of incident AF was attributable to an average achieved SBP ≥140 mm Hg. Conclusion: Among patients treated for hypertension, uncontrolled elevated SBP and SBP <120 mm Hg were associated with an increased risk of incident AF.

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