Pulse pressure is not an independent predictor of incident atrial fibrillation in 60-year-old men and women

Abstract

Aim To evaluate if pulse pressure (PP) is a risk predictor for atrial fibrillation (AF) in a longitudinal study of 60-year-old men and women from Stockholm (n = 4,232), free from AF at baseline, with primary end-point incident AF. Methods AF diagnoses were obtained from the national hospital discharge register. The estimated risk of AF associated with increasing PP values was calculated according to PP values above median (>52.5 mmHg) and according to 1-SD increase (14 mmHg) in PP, using a crude and an adjusted Cox proportional hazard regression model. Results During a mean follow-up of 13.6 years, 286 incident AF cases were recorded. The number of AF cases increased significantly with increasing PP quartile in men but not in women. PP values above median were associated with increased AF risk (crude HR 1.63, 95% CI 1.28–2.06; p < 0.001), but risk estimates were attenuated after adjustment for common AF risk factors. When PP was entered in the Cox regression model as a continuous variable, the risk of AF did not change by 1-SD PP increase (adjusted HR 1.04, 95% CI 0.91–1.20; p = 0.560). Conclusions PP seems not to be associated with incident AF in a Swedish population of 60-year-old men and women.

Key messages

• Atrial fibrillation is a highly prevalent disease with a partly unknown etiology.

• A better knowledge of the risk factors associated with the risk of atrial fibrillation may improve primary prevention strategies.

• Our results indicate that pulse pressure is not an independent risk factor for atrial fibrillation.

Keywords:

• Atrial fibrillation
• cardiovascular risk
• cohort study
• hypertension
• pulse pressure