High-normal BP in middle-aged men linked to atrial fibrillation later in life

Upper-normal blood pressures (BP) in otherwise healthy middle-aged men are long-term predictors of incident atrial fibrillation (AF) in older age, according to a study that appeared online January 17 in Hypertension. The study was conducted by a Swedish group led by Irene Grundvold, Department of Cardiology, Oslo University Hospital, Norway.

Researchers recruited 2,014 healthy middle-aged men from 1972 to 1975. They underwent a comprehensive clinical examination, including BP measurements. During up to 35 years of follow-up, 270 men were found to have developed AF. The majority of these developed the condition late in life, on average 20 years from baseline.

Men with baseline systolic BP ≥140 mm Hg and upper-normal BP 128 to 138 mm Hg had 1.60-fold (95% CI, 1.15–2.21) and 1.50-fold (1.10–2.03) risk of AF, respectively, compared with men with BP <128 mm Hg. Baseline diastolic BP ≥80 mm Hg increased the risk of incident AF 1.79-fold (95% CI, 1.28–2.59) compared with diastolic BP <80 mm Hg.

When adjusting for the occurrence of diabetes mellitus or cardiovascular diseases before an AF event, the results still maintained significance. Additional analyses, on average 7 years after baseline, including men still healthy, showed that sustained upper-normal systolic BP remained a significant predictor of subsequent AF.