Long-term blood pressure trajectories and incident atrial fibrillation in women and men: the Tromsø Study

Area of Science:

• Cardiology
• Epidemiology
• Public Health

Background:

• Atrial fibrillation (AF) is a common arrhythmia with significant cardiovascular implications.
• Understanding the long-term impact of blood pressure (BP) on AF risk is crucial for preventative strategies.
• Sex-specific differences in cardiovascular disease risk warrant investigation into differential BP pattern effects.

Purpose of the Study:

• To investigate the sex-specific associations between long-term individual blood pressure (BP) patterns and the risk of developing atrial fibrillation (AF).
• To identify distinct BP trajectories and their correlation with incident AF in a general population sample.

Main Methods:

• Utilized data from the Tromsø Study, including BP measurements from 8376 women and 7670 men across three surveys (1986-2001).
• Employed latent mixed modeling to define long-term systolic BP and hypertension trajectories.
• Applied Cox regression analysis to assess the relationship between identified BP trajectories and incident AF up to 2013.

Main Results:

• Persistently elevated systolic BP throughout the study period was linked to increased AF risk in both sexes, with a more pronounced effect in women.
• Women with elevated systolic BP trajectories showed doubled AF risk compared to those with low BP levels, regardless of BP trend.
• Men with increasing elevated systolic BP exhibited a 50% higher AF risk; women developing hypertension during the study also showed increased AF risk.

Conclusions:

• Long-term blood pressure and hypertension trajectories are significantly associated with increased AF incidence in both women and men.
• The association between BP patterns and AF risk is notably stronger in women compared to men.
• These findings highlight the importance of monitoring and managing BP over time for AF prevention, with particular attention to sex-specific risks.