P3776Blood pressure variability and incidence of new-onset atrial fibrillation

Abstract

Abstract Background Visit-to-visit blood pressure (BP) variability is a known risk factor for stroke, but the association between BP variability and atrial fibrillation (AF) incidence is uncertain. We sought to evaluate the association between BP variability and incident AF. Methods We identified 8,063,922 subjects (mean age 48 years; 59% men) who had ≥3 health checkups provided by the Korean National Health Insurance Corporation between 2004 and 2010. Systolic and diastolic BP variability was defined as variability independence of the mean (VIM). VIM was divided into four groups and high variability of BP was defined as the highest quartile values. The primary end point was new-onset atrial fibrillation. Results During a mean 7 years of follow-up, 140,086 subjects were newly diagnosed with AF (2.53 per 1000 person-years). High variation in BP was associated with an increase in the risk of AF (SBP: hazard ratio [HR], 1.060; 95% confidence interval [CI], 1.044–1.075, DBP: HR, 1.066; 95% CI, 1.050–1.082) compared with subjects with lowest quartile of BP. Among subjects with high variation both in SBP and DBP, the risk of AF was 7.6% higher than subjects without high variation in SBP and DBP. The risk of high BP variation on new-onset AF was more obvious in high-risk patients. The association of high BP variability with AF was being stronger for high-risk subjects who were older (≥65 years), with diabetes, or with CKD compared with subjects who were younger, without diabetes, or without CKD. Conclusions Fluctuation in SBP and DBP was associated with higher incidence of AF, especially in high-risk subjects, independent of traditional AF risk factors.