Lowering Systolic Blood Pressure Reduces AF Risk

Hypertensive patients that achieve their systolic blood pressure (SBP) target had lower atrial fibrillation (AF) incidence, according to a new study.

Researchers at Weill Cornell Medical College (New York, NY, USA), Ulleval Hospital (Oslo, Norway), and other institutions conducted a study to examine the risk of new-onset AF in relation to last in-treatment SBP before AF diagnosis. The study included 8,831 hypertensive patients with left ventricular hypertrophy and no history of AF, who were randomly assigned to losartan- or atenolol-based treatment. Patients with in-treatment SBP lower than 130 mmHg and SBP between 131 and 141 mmHg were compared with patients with in-treatment SBP higher than 142 mmHg.

The results showed that during follow-up of a mean 4.6 years, new-onset AF was diagnosed in 7.9% of the patients. The researchers calculated that every 10-mmHg decrease in SBP was associated with a 13% lower risk of new-onset AF, and that those patients who achieved SBP of 125 mmHg had a 40% lower risk for AF. Compared with the group with less-adequate SBP control, patients with typical SBP control had a 24% lower risk of developing AF. The study was published online on June 8, 2015, in Hypertension.

“Among hypertensive patients at high risk of atrial fibrillation who can tolerate lower systolic blood pressure (SBP) levels, treating to a SBP of 130 or less may be able to reduce or retard the incidence of new AF,” said lead author Peter Okin, MD, of Weill Cornell Medical College, in an interview with Reuters. “But caution should be used when treating to these lower SBP levels to make sure that we are not harming patients in other ways.”

There is a well-established association between hypertension and increased risk for stroke, coronary heart disease, and renal failure. Another common cardiovascular condition is atrial fibrillation (AF), the most commonly occurring sustained cardiac arrhythmia, which is associated with a high mortality and morbidity rate from stroke, thromboembolism, and heart failure. Studies have shown that the risk of stroke doubles in patients with AF who also suffer from hypertension.

Related Links:
Weill Cornell Medical College
Ullevål Hospital