RT Journal Article
SR Electronic
T1 Ambulatory blood pressure and long-term risk for atrial fibrillation
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP heartjnl-2017-312488
DO 10.1136/heartjnl-2017-312488
A1 Valérie Tikhonoff
A1 Tatiana Kuznetsova
A1 Lutgarde Thijs
A1 Nicholas Cauwenberghs
A1 Katarzyna Stolarz-Skrzypek
A1 Jitka Seidlerová
A1 Sofia Malyutina
A1 Natasza Gilis-Malinowska
A1 Ewa Swierblewska
A1 Kalina Kawecka-Jaszcz
A1 Jan Filipovský
A1 Krzysztof Narkiewicz
A1 Gregory Y H Lip
A1 Edoardo Casiglia
A1 Jan A Staessen
A1 ,
YR 2018
UL http://heart.bmj.com/content/early/2018/02/09/heartjnl-2017-312488.abstract
AB Objective Data on the contribution of ambulatory blood pressure (ABP) components to the risk of developing atrial fibrillation (AF) are limited. We prospectively tested the hypothesis that ABP may represent a potentially modifiable risk factor for the development of AF in a European population study.Methods We recorded daytime blood pressure (BP) in 3956 subjects randomly recruited from the general population in five European countries. Of these participants, 2776 (70.2%) underwent complete 24-hour ABP monitoring. Median follow-up was 14 years. We defined daytime systolic BP load as the percentage BP readings above 135 mm Hg. The incidence of AF was assessed from ECGs obtained at baseline and follow-up and from records held by general practitioners and/or hospitals.Results Overall, during 58 810 person-years of follow-up, 143 participants experienced new-onset AF. In adjusted Cox models, each SD increase in baseline 24 hours, daytime and night-time systolic BP was associated with a 27% (P=0.0056), 22% (P=0.023) and 20% (P=0.029) increase in the risk for incident AF, respectively. Conventional systolic BP was borderline associated with the risk of AF (18%; P=0.06). As compared with the average population risk, participants in the lower quartile of daytime systolic BP load (<3%) had a 51% (P=0.0038) lower hazard for incident AF, whereas in the upper quartile (>38%), the risk was 46% higher (P=0.0094).Conclusions Systolic ABP is a significant predictor of incident AF in a population-based cohort. We also observed that participants with a daytime systolic BP load >38% had significantly increased risk of incident AF.