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

Figures & data

Figure 1. Flow chart of the exclusion criteria adopted in the present study.

Table I. Baseline characteristics of men and women and entire cohort in incident AF cases and in the reference group.

	Men (n = 1,937)			Women (n = 2,125)			All (n = 4,062)
Variable	Incident AF (n = 161)	Reference group (n = 1,776)	p value	Incident AF (n = 125)	Reference group (n = 2,000)	p value	Incident AF (n = 286)	Reference group (n = 3,776)	p value
SBP, mmHg	148.3 ± 19.2	142.3 ± 20.7	0.0005	138.3 ± 24.1	134.0 ± 21.9	0.0312	143.9 ± 22.0	137.9 ± 21.7	<0.001
DBP, mmHg	90.2 ± 10.4	87.4 ± 10.5	0.0009	83.2 ± 10.1	81.4 ± 9.9	0.0597	87.1 ± 10.8	84.2 ± 10.6	<0.001
MAP, mmHg	109.6 ± 12.7	105.7 ± 13.3	0.0004	101.6 ± 14.1	98.9 ± 13.3	0.0346	106.1 ± 13.9	102.1 ± 13.7	<0.001
PP, mmHg	58.1 ± 12.1	55.0 ± 13.0	0.0042	55.2 ± 17.0	52.5 ± 14.6	0.0506	56.8 ± 14.5	53.7 ± 13.9	0.0003
BMI (kg/m^2)	27.9 ± 4.1	26.9 ± 3.7	0.0021	28.1 ± 5.8	26.6 ± 4.5	0.0004	28.0 ± 4.9	26.7 ± 4.2	<0.001
Total cholesterol (mmol/L)	5.83 ± 1.05	5.79 ± 1.02	0.6174	6.14 ± 1.08	5.98 ± 1.11	0.1142	5.90 ± 1.08	5.97 ± 1.07	0.2356
Hypertension	122 (75.8)	1072 (60.4)	<0.001	68 (54.4)	898 (44.9)	0.039	190 (66.4)	1,970 (52.2)	<0.001
Diabetes	21 (13.0)	163 (9.2)	0.109	8 (6.4)	99 (5.0)	0.474	29 (10.1)	262 (6.9)	0.043
Current smoker	36 (22.4)	362 (20.7)	0.624	29 (23.4)	439 (22.3)	0.775	65 (22.8)	801 (21.6)	0.619
Prior CHD	44 (27.3)	330 (18.6)	0.007	15 (12.0)	160 (8.0)	0.115	59 (20.6)	490 (13.0)	<0.001
Prior MI	26 (16.2)	197 (11.1)	0.054	6 (4.8)	75 (3.8)	0.552	32 (11.2)	272 (7.2)	0.014
History of angina	25 (15.5)	171 (9.6)	0.017	10 (8.0)	96 (4.8)	0.111	35 (12.2)	267 (7.1)	0.001
History of heart failure	2 (1.2)	17 (1.0)	0.725	3 (2.4)	21 (1.1)	0.166	5 (1.8)	38 (1.0)	0.237
ECG-LVH	32 (19.9)	163 (9.2)	<0.001	9 (7.2)	110 (5.5)	0.423	41 (14.3)	273 (7.2)	<0.001
Education >9 years	74 (46.3)	757 (43.1)	0.443	46 (36.8)	760 (38.4)	0.730	120 (42.1)	1,517 (40.6)	0.614

Values are presented as mean ± standard deviation (SD); or as numbers (n) of subjects and percentages in parentheses. Information on smoking was missing in 29 men and in 31 women. Lab data including serum glucose and total cholesterol were missing in 2 women, resulting in missing information about presence of diabetes mellitus and total cholesterol. Information on the occurrence of ECG-LVH was missing in 3 men and 1 woman. Information on education level was missing in 21 men and 18 women.

AF = atrial fibrillation; BMI = body mass index; CHD = coronary heart disease; DBP = diastolic blood pressure; ECG-LVH = electrocardiographic left ventricular hypertrophy; MAP = mean arterial pressure; MI = myocardial infarction; PP = pulse pressure; SBP = systolic blood pressure.

Figure 2. Cumulative AF incidence according to PP quartiles. Cut-off points denoting PP quartiles were at 44.0, 52.5, and 62.5 mmHg. Q1, ≤44.0 mmHg; Q2, 44.1–52.5 mmHg; Q3, 52.6–62.5 mmHg; and Q4, >62.5 mmHg.

Table II. Hazard ratio (HR) and 95% confidence interval (CI) for incident AF per 1-SD increase in PP.

Model	Men HR (95% CI)	Women HR (95% CI)	All HR (95% CI)
Unadjusted	1.26 (1.09–1.46) p = 0.002	1.19 (1.00–1.40) p = 0.045	1.24 (1.11–1.38) p < 0.001
Multivariate model	1.12 (0.97–1.31) p = 0.129	1.14 (0.96–1.36) p = 0.136	1.13 (1.01–1.27) p = 0.035
Multivariate model + hypertension	1.02 (0.85–1.21) p = 0.862	1.09 (0.87–1.35) p = 0.464	1.04 (0.91–1.20) p = 0.560

1 SD = 13.0 mmHg in men, 14.8 mmHg in women and 14.0 mmHg in all. The unadjusted model included 4,062 individuals. The multivariate model included 3,996 individuals and was adjusted for BMI, smoking, diabetes, prior MI, history of heart failure and ECG-LVH. The multivariate analysis of the entire population (all) was sex-adjusted.

Table III. Hazard ratio (HR) and 95% confidence interval (CI) for incident AF per 1-SD increase in PP in normotensive and hypertensive individuals, respectively.

	Men HR (95% CI)	Women HR (95% CI)	All HR (95% CI)
Normotensive	1.32 (0.73–2.39) p = 0.353	0.77 (0.49–1.19) p = 0.239	0.93 (0.66–1.32) p = 0.693
Hypertensive	1.06 (0.88–1.28) p = 0.525	1.21 (0.95–1.55) p = 0.127	1.10 (0.94–1.28) p = 0.223

1 SD = 13.0 mmHg in men, 14.8 mmHg in women and 14.0 mmHg in all. The number of normotensive individuals included in the analysis was 1,902; 743 men and 1,159 women. The number of hypertensive individuals included in the analysis was 2,160; 1,194 men and 966 women. All analyses are crude.