Hypertension, obesity exert synergistic effect on risk of new-onset atrial fibrillation

Uncontrolled, long-standing hypertension is especially detrimental with respect to the risk of developing new-onset atrial fibrillation (AF), a study finds. Furthermore, the degree and duration of high blood pressure act synergistically with body weight status, such that obese individuals with hypertension have the highest AF risk.

The study population comprised 9,797,418 individuals who underwent a national health check-up. A total of 2,486,705 individuals (25.38 percent) were diagnosed with hypertension, among whom 863,727 (34.73 percent) were unmedicated, 750,354 (30.17 percent) took medication for <5 years and 872,624 (35.09 percent) underwent treatment for ≥5 years. Among individuals without hypertension, 3,911,896 (53.51 percent) were prehypertensive.

New-onset AF occurred in 196,136 participants over a mean of 8.2 years of follow-up. The risk of new-onset AF increased progressively with the degree of hypertension. The adjusted hazard ratios with nonhypertension as reference were 1.145 with prehypertension, 1.390 with unmedicated hypertension, 1.853 with hypertension with <5 years of medication and 2.344 with hypertension with ≥5 years of medication.

New-onset AF incidence was also associated with body mass index and waist circumference, with obesity exerting a synergistic effect with hypertension. The greatest risk of new-onset AF was observed in obese people with hypertension on medication ≥5 years.

The present data point to the importance of maintaining adequate blood pressure and body weight for preventing new-onset AF, researchers said.