Impact of the Duration and Degree of Hypertension and Body Weight on New-Onset Atrial Fibrillation: A Nationwide Population-Based Study
- Authors
- Kim, Yun Gi; Han, Kyung-Do; Choi, Jong-Il; Boo, Ki Yung; Kim, Do Young; Oh, Suk-Kyu; Lee, Kwang-No; Shim, Jaemin; Kim, Jin Seok; Kim, Young-Hoon
- Issue Date
- Nov-2019
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- atrial fibrillation; body weight; obesity; risk factor; waist circumference
- Citation
- HYPERTENSION, v.74, no.5, pp.E45 - E51
- Journal Title
- HYPERTENSION
- Volume
- 74
- Number
- 5
- Start Page
- E45
- End Page
- E51
- URI
- http://scholarworks.bwise.kr/ssu/handle/2018.sw.ssu/38857
- DOI
- 10.1161/HYPERTENSIONAHA.119.13672
- ISSN
- 0194-911X
- Abstract
- Hypertension and obesity are known risk factors for atrial fibrillation (AF). However, it is unclear whether uncontrolled, long-standing hypertension has a particularly profound effect on AF. Because they have a similar underlying pathophysiology, hypertension and obesity could act synergistically in the context of AF. We evaluated how various stages of hypertension and body weight status affect new-onset AF. We analyzed a total of 9797418 participants who underwent a national health checkup. Hypertension was classified into 5 stages: nonhypertension, prehypertension, hypertension without medication, hypertension with medication <5 years, and hypertension with medication <greater than or equal to>5 years. The participants were also stratified based on body mass index and waist circumference. During the 80130161 personxyears follow-up, a total of 196136 new-onset AF cases occurred. The incidence of new-onset AF gradually increased among the 5 stages of hypertension: the adjusted hazard ratio for each group was 1 (reference), 1.145, 1.390, 1.853, and 2.344 for each stage of hypertension. A graded escalation in the risk of new-onset AF was also observed in response to increased systolic and diastolic blood pressure. The incidence of new-onset AF correlated with body mass index and waist circumference, with obese people having a higher risk than others. Hypertension and obesity acted synergistically: obese people with hypertension on medication >= 5 years had the highest risk of AF. In conclusion, the degree and duration of hypertension, as well as the presence of hypertension, were important factors for new-onset AF. Body weight status was significantly associated with new-onset AF and acted synergistically with hypertension.
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