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Hypertension Burden and the Risk of New-Onset Atrial Fibrillation: A Nationwide Population-Based Study

So-Ryoung Lee1, Chan Soon Park2, Eue-Keun Choi1,3

  • 1From the Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (S.-R.L., E.-K.C., H.-J.A., S.O.).

Hypertension (Dallas, Tex. : 1979)
|January 25, 2021
PubMed

Insights

Higher hypertension burden significantly increases the risk of developing atrial fibrillation (AF). Managing blood pressure tailored to individual needs is crucial for AF prevention.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • The cumulative impact of hypertension on atrial fibrillation (AF) development remains incompletely understood.
  • Previous studies have not fully elucidated the dose-response relationship between hypertension burden and incident AF.

Purpose of the Study:

  • To investigate the association between the cumulative burden of hypertension and the incidence of atrial fibrillation.
  • To quantify the risk of developing AF based on varying degrees of hypertension exposure.

Main Methods:

  • Utilized the Korean National Health Insurance Service database, including 3,726,172 individuals with four annual health checkups (2009-2013).
  • Assessed hypertension burden using consecutive blood pressure measurements (systolic BP ≥130 mmHg or diastolic BP ≥80 mmHg), stratified into scales 0-4.
  • Followed participants for a median of 5.2 years to identify new diagnoses of AF.

Main Results:

  • A total of 22,012 new AF cases were diagnosed during the follow-up period.
  • Compared to individuals with no hypertension, those with hypertension burden scales 1, 2, 3, and 4 showed an 8%, 18%, 26%, and 27% increased risk of incident AF, respectively.
  • Further stratification revealed that the risk of AF increased by up to 71% with higher stages of hypertension, indicating a dose-dependent relationship.

Conclusions:

  • Both sustained exposure to elevated blood pressure and the severity of hypertension significantly correlate with an increased risk of incident AF.
  • Emphasizes the need for tailored blood pressure management strategies to mitigate the risk of developing atrial fibrillation.

Keywords:
atrial fibrillationblood pressurehypertensionprognosisrisk

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