Abstract
The aim of this study was to explore sex-specific associations between systolic blood pressure (SBP), hypertension, and the risk of incident atrial fibrillation (AF) subtypes, including paroxysmal, persistent, and permanent AF, in a general population. A total of 13,137 women and 11,667 men who participated in the fourth survey of the Tromsø Study (1994–1995) were followed up for incident AF until the end of 2016. Cox proportional hazards regression analysis was conducted using fractional polynomials for SBP to provide sex- and AF-subtype-specific hazard ratios (HRs) for SBP. An SBP of 120 mmHg was used as the reference. Models were adjusted for other cardiovascular risk factors. Over a mean follow-up of 17.6 ± 6.6 years, incident AF occurred in 914 (7.0%) women (501 with paroxysmal/persistent AF and 413 with permanent AF) and 1104 (9.5%) men (606 with paroxysmal/persistent AF and 498 with permanent AF). In women, an SBP of 180 mmHg was associated with an HR of 2.10 (95% confidence interval [CI] 1.60–2.76) for paroxysmal/persistent AF and an HR of 1.80 (95% CI 1.33–2.44) for permanent AF. In men, an SBP of 180 mmHg was associated with an HR of 1.90 (95% CI 1.46–2.46) for paroxysmal/persistent AF, while there was no association with the risk of permanent AF. In conclusion, increasing SBP was associated with an increased risk of both paroxysmal/persistent AF and permanent AF in women, but only paroxysmal/persistent AF in men. Our findings highlight the importance of sex-specific risk stratification and optimizing blood pressure management for the prevention of AF subtypes in clinical practice.
Highlights
IntroductionIt has been shown that tight blood pressure control may reduce the risk of atrial fibrillation (AF) up to 50% [7]
We found that individuals with controlled hypertension had a risk of paroxysmal/persistent atrial fibrillation (AF) that was comparable to that of normotensive participants, while controlled hypertension was associated with an increased risk of permanent AF in both sexes, but especially in women
We found stronger associations between systolic blood pressure (SBP) and AF subtypes, especially permanent AF, in women compared to men, which may demonstrate the necessity of sexspecific optimal blood pressure targets and/or treatment thresholds, as well as sex-specific
Summary
It has been shown that tight blood pressure control may reduce the risk of AF up to 50% [7]. Previous studies have shown that hypertension promotes the progression from paroxysmal AF to more sustained forms of the disease [8,9,10]. Many of these studies investigated the effect of hypertension in patients with established paroxysmal AF, while longitudinal studies examining the association between blood pressure and AF subtypes in a population without AF at baseline are sparse [11,12]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
