Middle-aged men with upper-normal BP at increased risk for AF
MedWire News: Middle-aged men with upper-normal systolic blood pressure (BP) are at significantly increased risk for atrial fibrillation (AF), say Norwegian researchers.
However, it is not yet known whether the subsequent development of hypertension among people with upper-normal BP is the essential pathway to incident AF, report Irene Grundvold from Oslo University Hospital, and co-authors.
Their prospective survey included 2014 healthy Norwegian men aged 40-59 years whose BP was measured at baseline. During up to 35 years of follow-up, 270 (13%) men developed AF, representing an incidence rate of 5.1 per 1000 person-years.
Risk estimates for incident AF were analyzed by quartiles of BP.
Men with a baseline systolic BP of at least 140 mmHg and an upper-normal BP of 128-138 mmHg had a significant 60% and 50% increased risk for AF, respectively, compared with men who had a BP of less than 128 mmHg.
Men with a baseline diastolic BP of at least 80 mmHg had a significant 79% increased risk for AF compared with men who had a baseline diastolic BP of less than 80 mmHg.
After adjusting for the occurrence of diabetes mellitus of cardiovascular disease before an AF event, these results remained statistically significant.
Additional analyses including 1423 healthy men conducted 7 years after baseline showed that sustained upper-normal systolic BP remained a significant predictor for subsequent AF.
"The present results imply that even middle-aged men with nonhypertensive BP levels according to current guidelines have an increased risk of developing AF," write the authors in Hypertension.
"We therefore propose further randomized clinical trials with improved BP control to aid in the challenge of preventing increasing AF in the general population."
In a related commentary, editorialists Paolo Verdecchia (Hospital of Assisi, Italy) et al say: "It is imperative that researchers make further analyses of existing databases and conduct properly designed intervention studies to clarify the relationship between BP control strategies and the risk of AF."
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By Piriya Mahendra