Normal Blood Pressure, High Normal Blood Pressure, and Risk of Incident Atrial Fibrillation: A Population‐Based Cohort Study

ABSTRACT Background and Aims This study aimed to investigate the association between normal BP, (blood pressure [BP] 120–129/80–84 mmHg), and high normal BP, (BP 130–139/85–89 mmHg), compared to optimal BP, and risk of atrial fibrillation (AF). Methods A population‐based cohort study was performed i...

Full description

Saved in:
Bibliographic Details
Main Authors: Cecilia Johansson, Lars Johansson, Marie Eriksson, Jonas Andersson, Marcus M. Lind
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Health Science Reports
Subjects:
Online Access:https://doi.org/10.1002/hsr2.71002
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849302834592350208
author Cecilia Johansson
Lars Johansson
Marie Eriksson
Jonas Andersson
Marcus M. Lind
author_facet Cecilia Johansson
Lars Johansson
Marie Eriksson
Jonas Andersson
Marcus M. Lind
author_sort Cecilia Johansson
collection DOAJ
description ABSTRACT Background and Aims This study aimed to investigate the association between normal BP, (blood pressure [BP] 120–129/80–84 mmHg), and high normal BP, (BP 130–139/85–89 mmHg), compared to optimal BP, and risk of atrial fibrillation (AF). Methods A population‐based cohort study was performed including inhabitants of Västerbotten County, Sweden, aged 30–60 years without AF at inclusion who participated in health examinations in 1988–2014. Approximately 40% of participants had ≥ 2 health examinations. The health examination included a questionnaire and measurement of BP, weight, height, and glucose. Cox regression with time‐updated covariates was used to estimate the association between BP and AF risk. Restricted cubic spline analyses were performed. Results The cohort included 109,697 persons with 162,982 observations and a mean follow‐up of 13.6 years. Incident AF was diagnosed in 5260 participants. We found an increased risk of incident AF associated with normal BP (hazard ratio [HR] 1.13, 95% confidence interval [CI] 1.01–1.27) and high normal BP (HR 1.23, 95% CI 1.10–1.38) compared to optimal BP after multivariable adjustment. Systolic BP and diastolic BP in 10 mmHg increments were associated with risk of incident AF, with HRs of 1.11 (95% CI 1.10–1.13) and 1.13 (95% CI 1.09–1.16), respectively, in multivariable models. A restricted cubic spline analysis indicated that the AF risk increased gradually with increasing systolic and diastolic BP. Conclusion Individuals with both normal BP and high normal BP have an increased risk of developing incident AF. The risk of AF increased gradually with increasing systolic and diastolic BP.
format Article
id doaj-art-5e1b6ee4b71a4d32b9af1d8bd5067313
institution Kabale University
issn 2398-8835
language English
publishDate 2025-07-01
publisher Wiley
record_format Article
series Health Science Reports
spelling doaj-art-5e1b6ee4b71a4d32b9af1d8bd50673132025-08-20T04:02:06ZengWileyHealth Science Reports2398-88352025-07-0187n/an/a10.1002/hsr2.71002Normal Blood Pressure, High Normal Blood Pressure, and Risk of Incident Atrial Fibrillation: A Population‐Based Cohort StudyCecilia Johansson0Lars Johansson1Marie Eriksson2Jonas Andersson3Marcus M. Lind4Department of Public Health and Clinical Medicine, Skellefteå Research Unit Umeå University Skellefteå SwedenDepartment of Public Health and Clinical Medicine, Skellefteå Research Unit Umeå University Skellefteå SwedenDepartment of Statistics, USBE Umeå University Umeå SwedenDepartment of Public Health and Clinical Medicine, Skellefteå Research Unit Umeå University Skellefteå SwedenDepartment of Public Health and Clinical Medicine, Skellefteå Research Unit Umeå University Skellefteå SwedenABSTRACT Background and Aims This study aimed to investigate the association between normal BP, (blood pressure [BP] 120–129/80–84 mmHg), and high normal BP, (BP 130–139/85–89 mmHg), compared to optimal BP, and risk of atrial fibrillation (AF). Methods A population‐based cohort study was performed including inhabitants of Västerbotten County, Sweden, aged 30–60 years without AF at inclusion who participated in health examinations in 1988–2014. Approximately 40% of participants had ≥ 2 health examinations. The health examination included a questionnaire and measurement of BP, weight, height, and glucose. Cox regression with time‐updated covariates was used to estimate the association between BP and AF risk. Restricted cubic spline analyses were performed. Results The cohort included 109,697 persons with 162,982 observations and a mean follow‐up of 13.6 years. Incident AF was diagnosed in 5260 participants. We found an increased risk of incident AF associated with normal BP (hazard ratio [HR] 1.13, 95% confidence interval [CI] 1.01–1.27) and high normal BP (HR 1.23, 95% CI 1.10–1.38) compared to optimal BP after multivariable adjustment. Systolic BP and diastolic BP in 10 mmHg increments were associated with risk of incident AF, with HRs of 1.11 (95% CI 1.10–1.13) and 1.13 (95% CI 1.09–1.16), respectively, in multivariable models. A restricted cubic spline analysis indicated that the AF risk increased gradually with increasing systolic and diastolic BP. Conclusion Individuals with both normal BP and high normal BP have an increased risk of developing incident AF. The risk of AF increased gradually with increasing systolic and diastolic BP.https://doi.org/10.1002/hsr2.71002atrial fibrillationblood pressurecohort studyhypertensionrisk factor
spellingShingle Cecilia Johansson
Lars Johansson
Marie Eriksson
Jonas Andersson
Marcus M. Lind
Normal Blood Pressure, High Normal Blood Pressure, and Risk of Incident Atrial Fibrillation: A Population‐Based Cohort Study
Health Science Reports
atrial fibrillation
blood pressure
cohort study
hypertension
risk factor
title Normal Blood Pressure, High Normal Blood Pressure, and Risk of Incident Atrial Fibrillation: A Population‐Based Cohort Study
title_full Normal Blood Pressure, High Normal Blood Pressure, and Risk of Incident Atrial Fibrillation: A Population‐Based Cohort Study
title_fullStr Normal Blood Pressure, High Normal Blood Pressure, and Risk of Incident Atrial Fibrillation: A Population‐Based Cohort Study
title_full_unstemmed Normal Blood Pressure, High Normal Blood Pressure, and Risk of Incident Atrial Fibrillation: A Population‐Based Cohort Study
title_short Normal Blood Pressure, High Normal Blood Pressure, and Risk of Incident Atrial Fibrillation: A Population‐Based Cohort Study
title_sort normal blood pressure high normal blood pressure and risk of incident atrial fibrillation a population based cohort study
topic atrial fibrillation
blood pressure
cohort study
hypertension
risk factor
url https://doi.org/10.1002/hsr2.71002
work_keys_str_mv AT ceciliajohansson normalbloodpressurehighnormalbloodpressureandriskofincidentatrialfibrillationapopulationbasedcohortstudy
AT larsjohansson normalbloodpressurehighnormalbloodpressureandriskofincidentatrialfibrillationapopulationbasedcohortstudy
AT marieeriksson normalbloodpressurehighnormalbloodpressureandriskofincidentatrialfibrillationapopulationbasedcohortstudy
AT jonasandersson normalbloodpressurehighnormalbloodpressureandriskofincidentatrialfibrillationapopulationbasedcohortstudy
AT marcusmlind normalbloodpressurehighnormalbloodpressureandriskofincidentatrialfibrillationapopulationbasedcohortstudy