Sex Differences in the Association Between Hypertension and Incident Atrial Fibrillation

Area of Science:

• Cardiology
• Hypertension Research
• Epidemiology

Background:

• Limited data exists on sex-based differences in the hypertension-atrial fibrillation (AF) link.
• Hypertension is a known risk factor for cardiovascular diseases, including AF.

Purpose of the Study:

• To investigate sex differences in the association between hypertension and incident AF.
• To analyze the relationship between blood pressure levels and AF risk in men and women.

Main Methods:

• Analysis of a nationwide health checkup and claims database of over 3.3 million adults.
• Utilized Cox regression and restricted cubic spline models to assess hypertension and AF risk.
• Categorized participants based on 2017 ACC/AHA blood pressure guidelines.

Main Results:

• Higher AF incidence observed in men (15.8/10,000 person-years) compared to women (6.1/10,000 person-years).
• Elevated blood pressure, stage 1, and stage 2 hypertension were linked to increased AF risk in both sexes.
• The association between hypertension and AF risk was significantly greater in women (P interaction=0.0076).
• Elevated systolic blood pressure showed increased AF risk above 130 mmHg in men and 100 mmHg in women.

Conclusions:

• While men have a higher incidence of AF, the risk associated with hypertension is more pronounced in women.
• Findings suggest a significant sex difference in how hypertension influences the development of AF.
• The heightened risk in women was particularly notable in younger individuals.