Hypertension. 2021;77(3):919-928.
Hypertension Burden and the Risk of New-Onset Atrial Fibrillation: A Nationwide Population-Based Study.
제1저자 이소령, 박찬순 · 교신저자 최의근
소속 (6)
- From the Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Republic of Korea (S.-R.L., E.-K.C., H.-J.A., S.O.).
- Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, Daejeon (C.S.P.).
- Department of Internal Medicine, Seoul National University College of Medicine, Republic of Korea (E.-K.C., S.O., G.Y.H.L.).
- Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea (K.-D.H.).
- Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart and Chest Hospital, United Kingdom (G.Y.H.L.).
- Department of Clinical Medicine, Aalborg University, Denmark (G.Y.H.L.).
Abstract
The association between the cumulative hypertension burden and the development of atrial fibrillation (AF) is unclear. We aimed to investigate the relationship between hypertension burden and the development of incident AF. Using the Korean National Health Insurance Service database, we identified 3 726 172 subjects who underwent 4 consecutive annual health checkups between 2009 and 2013, with no history of AF. During the median follow-up of 5.2 years, AF was newly diagnosed in 22 012 patients (0.59% of the total study population; 1.168 per 1000 person-years). Using the blood pressure (BP) values at each health checkup, we determined the burden of hypertension (systolic BP ≥130 mm Hg or diastolic BP ≥80 mm Hg), stratified as 0 to 4 per the hypertension criteria. The subjects were grouped according to hypertension burden scale 1 to 4: 20% (n=742 806), 19% (n=704 623), 19% (n=713 258), 21% (n=766 204), and 21% (n=799 281). Compared with normal people, subjects with hypertension burdens of 1, 2, 3, and 4 were associated with an 8%, 18%, 26%, and 27% increased risk of incident AF, respectively. On semiquantitative analyses with further stratification of stage 1 (systolic BP of 130-139 mm Hg or diastolic BP of 80-89 mm Hg) and stage 2 (systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg) hypertension, the risk of AF increased with the hypertension burden by up to 71%. In this study, both a sustained exposure and the degree of increased BP were associated with an increased risk of incident AF. Tailored BP management should be emphasized to reduce the risk of AF.
Keywords
atrial fibrillationblood pressurehypertensionprognosisrisk
그 밖의 정보
- 출판 형태
- Journal Article, Research Support, Non-U.S. Gov't
- 저널
- Hypertension (Dallas, Tex. : 1979) · eISSN 1524-4563
- 전자 출판
- 2021-01-25
- MeSH
- Adult · Age of Onset · Atrial Fibrillation / diagnosis / epidemiology · Blood Pressure / physiology · Cost of Illness* · Female · Humans · Hypertension / diagnosis / epidemiology / physiopathology · Incidence · Kaplan-Meier Estimate · Male · Middle Aged · Republic of Korea / epidemiology · Risk Factors