Hypertension tied to higher risk for HF, AF in patients with no history of CVD


Disclosures:
Kaneko and another author report they received research and scholarship funding from Biotronik Japan, Boston Scientific Japan, Fukuda Denshi Central Tokyo, Medtronic Japan and Simplex Quantum.


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Elevated BP and stage 1 and stage 2 hypertension were associated with a greater frequency of HF, atrial fibrillation and other CVDs compared with normal BP in the general population, according to a study published in Circulation.

“The categorization based on the 2017 American College of Cardiology/American Heart Association Blood Pressure guidelines may improve risk stratification for identifying adults at high risk for heart failure and atrial fibrillation events,” Hidehiro Kaneko, MD, of the department of cardiovascular medicine and the department of advanced cardiology, University of Tokyo, and colleagues wrote.



Elevated BP and stage 1 and stage 2 hypertension were associated with a greater frequency of HF, atrial fibrillation and other CVDs compared with normal BP in the general population. Data were derived from Kaneko H, et al. Circulation. 2021;doi:10.1161/CIRCULATIONAHA.120.052624.

Researchers analyzed a health claims database collected by the Japan Medical Data Center from 2005 to 2018 that included 2,196,437 participants without prior CVD or antihypertensive medication use (mean age, 44 years; 58% men). Mean follow-up was 1,112 days.

According to the definitions from the guidelines, elevated BP is 120 mm Hg to 129 mm Hg/< 80 mm Hg, stage 1 hypertension is 130 mm Hg to 139 mm Hg/80 mm Hg to 89 mm Hg, and stage 2 hypertension is at least 140/90 mm Hg.

After multivariable adjustments, compared with normal BP, elevated BP, stage 1 hypertension and stage 2 hypertension were associated with elevated risk for HF and AF (elevated BP: HR for HF = 1.1; 95% CI, 1.05-1.15; HR for AF = 1.07; 95% CI, 0.99-1.17; stage 1 hypertension: HR for HF = 1.3; 95% CI, 1.26-1.35; HR for AF = 1.21; 95% CI, 1.13-1.29; stage 2 hypertension: HR for HF = 2.05; 95% CI, 1.97-2.13; HR for AF = 1.52; 95% CI, 1.41-1.64).

Population attributable fractions for HF associated with stage 1 and stage 2 hypertension were 23.2% (95% CI, 20.3-26) and 51.2% (95% CI, 49.2%-53.1%), respectively, whereas population attributable fractions for AF associated with stage 1 and stage 2 hypertension were 17.4% (95% CI, 11.5-22.9) and 34.3% (95% CI, 29.1-39.2), respectively, the researchers wrote.

“The ACC/AHA BP classification system may help identify adults at higher risk for HF and AF events,” the researchers wrote.