( Increased pulse pressure (the differenc...)Pulse Pressure Identified as Important Risk Factor for Atrial Fibrillation,Health

Increased pulse pressure (the difference between systolic and diastolic blood pressure) appears to be an important predictor of the risk// for new onset atrial fibrillation, according to a study.

Atrial fibrillation (AF) is the most common chronic arrhythmia in adults and is associated with increased risk for death and stroke. An estimated 2.3 million adults in the United States have AF, and that number is expected to increase substantially as the population ages, making identification of modifiable risk factors important. The prevalence of AF increases with age, with a substantial overall lifetime risk of approximately 1 in 4 for both men and women, according to background information in the article. The increase in AF incidence with age coincides with a rapid age-related increase in aortic stiffness, which is associated with increased pulse pressure, which increases cardiac load and may increase AF risk.

Gary F. Mitchell, M.D., of Cardiovascular Engineering Inc., Waltham, Mass., and colleagues examined the association between pulse pressure and the development of AF. The study included 5,331 participants of the Framingham Heart Study who were age 35 years and older and initially free from AF (median [midpoint] age, 57 years; 55 percent women).

During an average of 16 years of follow-up, 363 men and 335 women developed AF with a median time-to-event of 12 years after pulse pressure assessment. The researchers found that after adjusting for age and sex, a 20 mm Hg increase in pulse pressure was associated with a 34 percent increase in the risk for developing AF. The association between pulse pressure and AF remained significant after further adjusting for average arterial pressure and clinical risk factors for AF; each 20 mm Hg increase in pulse pressure was associated with a 24 percent increase in the risk for developing AF. In contrast, average arterial pressure was not associated with increased risk for developing AF.


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