1 Department of Molecular and Clinical Medicine, University of Gothenburg, Sweden.
2 Department of Public Health and Community Medicine, University of Gothenburg, Sweden.
Eur J Prev Cardiol. 2017 Jul;24(11):1206-1211. doi: 10.1177/2047487317708266. Epub 2017 May 4.
Background Atrial fibrillation is associated with increased cardiovascular morbidity and mortality. Hypertension is an important risk factor for the development of atrial fibrillation. Aim This study assessed the relationship between blood pressure control and new-onset atrial fibrillation in hypertensive patients. Methods and results We followed 45,530 hypertensive patients with no previously documented atrial fibrillation, attending primary healthcare in Sweden during 2001-2008. After a mean follow-up of 3.5 years 2057 patients (4.5%) developed atrial fibrillation. Compared to patients with no atrial fibrillation, the new-onset atrial fibrillation group (after adjustment for age, sex, diabetes mellitus, heart failure, ischaemic heart disease, cerebrovascular disease and number of visits) had higher mean in-treatment systolic blood pressure (SBP) and diastolic blood pressure of 3.8 mmHg (95% confidence interval (CI) 3.0-4.6; P < 0.0001) and 1.6 mmHg (95% CI 1.2-2.0; P < 0.0001), respectively. Similarly, mean in-treatment pulse pressure in the new-onset atrial fibrillation group was 2.2 mmHg (95% CI 1.6-2.9; P < 0.001) higher. In a logistic regression analysis, achieved SBP ≥ 140 mmHg was associated with a higher risk of new-onset atrial fibrillation, compared to SBP 130-139 mmHg (odds ratio (OR) 1.5; 95% CI 1.3-1.7) and to SBP < 130 mmHg (OR 1.3; 95% CI 1.1-1.5). There was no difference in risk for new-onset AF between SBP 130-139 and <130 mmHg (OR 0.9; 95% CI 0.7-1.1). Conclusion The present findings indicate that blood pressure control in hypertension is associated with a lower risk of new-onset atrial fibrillation.
心房颤动与心血管发病率和死亡率的增加有关。高血压是心房颤动发展的一个重要危险因素。目的：本研究评估了高血压患者血压控制与新发心房颤动之间的关系。方法和结果：我们随访了 2001-2008 年期间在瑞典初级保健机构就诊的 45530 例无先前记录的心房颤动的高血压患者。在平均 3.5 年的随访后，2057 例患者（4.5%）发生了心房颤动。与无心房颤动的患者相比，新发心房颤动组（调整年龄、性别、糖尿病、心力衰竭、缺血性心脏病、脑血管疾病和就诊次数后）的治疗中收缩压和舒张压分别高出 3.8mmHg（95%置信区间 3.0-4.6；P<0.0001）和 1.6mmHg（95%置信区间 1.2-2.0；P<0.0001）。同样，新发心房颤动组的治疗中脉压平均高出 2.2mmHg（95%置信区间 1.6-2.9；P<0.001）。在逻辑回归分析中，与收缩压 130-139mmHg 相比，收缩压≥140mmHg 与新发心房颤动风险增加相关（比值比 1.5；95%置信区间 1.3-1.7），与收缩压<130mmHg 相比（比值比 1.3；95%置信区间 1.1-1.5）。收缩压 130-139mmHg 与<130mmHg 之间新发心房颤动的风险无差异（比值比 0.9；95%置信区间 0.7-1.1）。结论：本研究结果表明，高血压患者的血压控制与新发心房颤动风险降低相关。
