| Autor: |
Espnes H; Department of Community Medicine, UiT The Arctic University of Norway, 9019 Tromsø, Norway., Ball J; Centre for Research and Evaluation, Ambulance Victoria, Melbourne, VIC 3130, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia.; Baker Heart and Diabetes Institute, Melbourne, VIC 3004, Australia., Løchen ML; Department of Community Medicine, UiT The Arctic University of Norway, 9019 Tromsø, Norway., Wilsgaard T; Department of Community Medicine, UiT The Arctic University of Norway, 9019 Tromsø, Norway., Njølstad I; Department of Community Medicine, UiT The Arctic University of Norway, 9019 Tromsø, Norway., Mathiesen EB; Department of Clinical Medicine, Brain and Circulation Research Group, UiT The Arctic University of Norway, 9019 Tromsø, Norway.; Department of Neurology, University Hospital of North Norway, 9019 Tromsø, Norway., Gerdts E; Center for Research on Cardiac Disease in Women, Department of Clinical Science, University of Bergen, 5020 Bergen, Norway., Sharashova E; Department of Community Medicine, UiT The Arctic University of Norway, 9019 Tromsø, Norway. |
| Abstrakt: |
The aim of this study was to explore sex-specific associations between systolic blood pressure (SBP), hypertension, and the risk of incident atrial fibrillation (AF) subtypes, including paroxysmal, persistent, and permanent AF, in a general population. A total of 13,137 women and 11,667 men who participated in the fourth survey of the Tromsø Study (1994-1995) were followed up for incident AF until the end of 2016. Cox proportional hazards regression analysis was conducted using fractional polynomials for SBP to provide sex- and AF-subtype-specific hazard ratios (HRs) for SBP. An SBP of 120 mmHg was used as the reference. Models were adjusted for other cardiovascular risk factors. Over a mean follow-up of 17.6 ± 6.6 years, incident AF occurred in 914 (7.0%) women (501 with paroxysmal/persistent AF and 413 with permanent AF) and 1104 (9.5%) men (606 with paroxysmal/persistent AF and 498 with permanent AF). In women, an SBP of 180 mmHg was associated with an HR of 2.10 (95% confidence interval [CI] 1.60-2.76) for paroxysmal/persistent AF and an HR of 1.80 (95% CI 1.33-2.44) for permanent AF. In men, an SBP of 180 mmHg was associated with an HR of 1.90 (95% CI 1.46-2.46) for paroxysmal/persistent AF, while there was no association with the risk of permanent AF. In conclusion, increasing SBP was associated with an increased risk of both paroxysmal/persistent AF and permanent AF in women, but only paroxysmal/persistent AF in men. Our findings highlight the importance of sex-specific risk stratification and optimizing blood pressure management for the prevention of AF subtypes in clinical practice. |
