Above Which Blood Pressure Level Does the Risk of Atrial Fibrillation Increase?

Abstract

See related article, pp 198–204 Atrial fibrillation (AF), the most common sustained cardiac arrhythmia, occurs in 1% to 2% of the general population,1 and its incidence is growing. Mostly because of the progressive aging of the population, the prevalence of AF is expected to double over the next 50 years.1 AF is a potentially devastating condition for several reasons. It portends a 5-fold risk of stroke,2 and ischemic strokes that occur in people with AF are often fatal or leave surviving patients generally more disabled and at higher risk of recurrences compared with other causes of stroke. AF triples the risk of heart failure,3 doubles the risk of dementia, and markedly increases the risk of all-cause mortality.4 For the above reasons, prevention of AF through appropriate control of its modifiable risk factors is a public health priority. Unfortunately, despite numerous experimental and clinical studies, the individual risk of developing AF in a given time frame is still difficult to estimate.5 Hypertension is a well-known modifiable risk factor for AF,3,4 although it is unclear above which blood pressure (BP) level the risk of AF definitely increases and, even more important, which target BP level should be pursued to reduce the risk of AF in treated hypertensive patients. In a population based, case-control study of 433 patients with incident AF and 899 controls, the risk of AF doubled in participants with systolic BP ≥150 …