Association of systolic blood pressure with atrial fibrillation among treated hypertensive patients

Abstract

Background: Although many studies have suggested the association between elevated blood pressure and atrial fibrillation (AF), how the relationship between systolic blood pressure (SBP) and AF differ by antihypertensive treatment has been unclear. Therefore, this study aimed to explore the relationship between SBP and AF in hypertensive patients with or without antihypertensive treatment.Methods: This was a cross-sectional study that enrolled 7,808 hypertensive patients aged ≥18 years old in 2013 in Guangdong, China. AF was screened and diagnosed by rest 12-lead electrocardiogram (ECG) or by self-reported. Patients were categorized into 5 groups according to a 10 mmHg increment in SBP. We then performed logistic regression and restricted cubic spline regression to evaluate the relationship between SBP and AF.Results: Out of 7,808 participants (women 52.9%, mean age 62.3 years), 78 cases of AF were identified.Both univariate and multivariate logistic regression illustrated that SBP associated with a lower chance of AF in all participants when SBP was treated as a continuous variable (P<0.05) or as a categorical variable (P for trend <0.001). Similar trend was found in patients with antihypertensive therapy (P for trend <0.001) but not for those without antihypertensive medications.Conclusions: Our findings suggested that higher SBP is associated with lower likelihood of AF among all hypertensive patients and participants with antihypertensive treatment.

Effects of REDOX in Regulating and Treatment of Metabolic and Inflammatory Cardiovascular Diseases

“…Atrial Fibrillation (AF). Atrial fibrillation (AF) is the most common arrhythmia in clinics, and its risk increases with age [119]. Both human and animal data confirm the role of oxidative stress in the pathogenesis of AF [120,121].…”

“…E2F1/miR-30b/Cyclophilin D forms a pathway in regulating hydrogen peroxideinduced necrotic cell death [116]. During hydrogen peroxide induced apoptosis, Wang et al found that both E2F1/miR-421/Pink signal pathway and miR-361/PHB1 function in regulating mitochondria fission and apoptosis [118,119]. All these results indicate that functional noncoding RNAs also play important role in a series of hydrogen peroxideinduced cellular responses.…”

Explainable Machine Learning for Atrial Fibrillation in the General Population Using a Generalized Additive Model ― A Cross-Sectional Study ―

“… 30 In subjects receiving antihypertensive treatment, a J-shaped relationship between SBP and AF was observed. 31 , 32 In the present study, SBP in the range 100–120 mmHg was more likely to complicate AF than SBP above that range, and there was no J-shaped relationship between SBP and AF. We present 3 hypotheses regarding the negative correlation between SBP and AF: (1) low SBP may, indeed, increase the risk of AF via chronic coronary ischemia, myocardial proliferation, and fibrosis induced by inadequate coronary perfusion; (2) low SBP may be the result of AF or AF-related cardiac structural and functional abnormalities; and (3) subjects with higher SBP are more likely to receive better clinical care and more antihypertensive medications, which play an important role in the mutually affected relationship between hypertension and AF.…”

“…30 In subjects receiving antihypertensive treatment, a J-shaped relationship between SBP and AF was observed. 31,32 In the present study, SBP in the range 100-120 mmHg was more likely to complicate AF than SBP above that range, and there was no J-shaped relationship between SBP and AF. We present 3 hypotheses regarding the negative correlation between SBP and AF:…”

Global, regional, and national burden of disease study of atrial fibrillation/flutter, 1990–2019: results from a global burden of disease study, 2019

“…Studies show that exposure to higher systolic blood pressure increases the risk of AF by 19% (advantage ratio of 1.19 [1.12 to 1.27] per 10 mmHg) [25]. Several studies have shown that effective blood pressure control is beneficial in reducing the incidence of AF/AFL [26][27][28]. In terms of the development of the attributable impact of high BMI, its contribution to the disease burden of AF/AFL is on the rise.…”