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Arrhythmias and sudden death
Original research
Associations of high-normal blood pressure and impaired fasting glucose with atrial fibrillation
  1. Juntae Kim1,
  2. Dongmin Kim1,
  3. Eunsun Jang2,
  4. Daehoon Kim2,
  5. Seng Chan You3,
  6. Hee Tae Yu2,
  7. Myung-Yong Lee1,
  8. Gregory Lip4,
  9. Pil-Sung Yang5,
  10. Boyoung Joung2
  1. 1 Division of Cardiology, Dankook University College of Medicine, Cheonan, Chungnam, Korea (the Republic of)
  2. 2 Division of Cardiology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  3. 3 Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)
  4. 4 Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
  5. 5 Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, Korea (the Republic of)
  1. Correspondence to Professor Boyoung Joung, Division of Cardiology, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of); cby6908{at}yuhs.ac; Professor Pil-Sung Yang, Division of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, Korea (the Republic of); psyang01{at}cha.ac.kr

Abstract

Objective To investigate the association of high-normal blood pressure (BP) and impaired fasting glucose (IFG) with the risk of atrial fibrillation (AF) in two cohorts.

Methods The Korean National Health Insurance Service-Health Screening (K-NHIS-HealS, 2002–2003, follow-up until 2013) Study and the UK Biobank (2007–2010, follow-up until 2021) were evaluated. We used Cox proportional hazards regression models to evaluate the associations of high-normal BP and IFG with incident AF.

Results In the K-NHIS-HealS and the UK Biobank, 2346 and 5314 incident AF events were recorded during the mean follow-up of 7.4 and 11.8 years. The adjusted HRs (95% CIs) for AF in the Korean and UK cohorts were 1.11 (1.02 to 1.21) and 1.07 (1.01 to 1.13) in individuals with high-normal BP; and 1.14 (1.04 to 1.25) and 1.10 (1.01 to 1.20) in individuals with IFG, respectively. The AF risk showed a dose–response relationship with BP and fasting blood glucose level. The risk of incident AF was increased by the combination of high-normal BP and IFG.

Conclusions In healthy individuals, high-normal BP and IFG were important risk factors for AF. When high-normal BP and IFG were combined, the risk of new-onset AF was significantly increased. These findings may suggest that lifestyle interventions for high-normal BP and IFG should be considered to reduce the risk of AF.

  • atrial fibrillation
  • hypertension
  • diabetes mellitus

Data availability statement

Data are available upon reasonable request.

http://dx.doi.org/10.1136/heartjnl-2022-322094

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • JK and DK are joint first authors.

    • P-SY and BJ are joint senior authors.

    • Contributors JK and BJ designed the study. P-SY, EJ, DHK and SCY assisted with data acquisition and interpretation. JK, P-SY and EJ performed statistical analyses. GL, DK and SCY contributed to the discussion. JK, DK and M-YL drafted the manuscript. BJ and HTY revised the manuscript. All authors read and approved the final manuscript.

    • Funding This research was supported by a grant of Patient-Centered Clinical Research Coordinating Center (PACEN) funded by the Ministry of Health & Welfare, Republic of Korea (HC19C0130).

    • Competing interests BJ has served as a speaker for Bayer, BMS/Pfizer, Medtronic and Daiichi-Sankyo, and received research funds from Medtronic and Abbott. GL has served as a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim and Daiichi-Sankyo. SCY reports being a chief technology officer of the PHI Digital Healthcare, and received a consulting fee from IQVIA. BJ, GL and SCY have received no fees directly or personally.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.