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What Is the Ideal Blood Pressure Threshold for the Prevention of Atrial Fibrillation in Elderly General Population?

Intensive blood pressure (BP) lowering in patients with hypertension at increased risk of cardiovascular disease has been associated with a lowered risk of incident atrial fibrillation (AF). It is uncertain whether maintaining the optimal BP levels can prevent AF in the general elderly population. W...

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Autores principales: Park, Yoon Jung, Yang, Pil-Sung, Yu, Hee Tae, Kim, Tae-Hoon, Jang, Eunsun, Uhm, Jae-Sun, Pak, Hui-Nam, Lee, Moon-Hyoung, Lip, Gregory Y.H., Joung, Boyoung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7563734/
https://www.ncbi.nlm.nih.gov/pubmed/32947828
http://dx.doi.org/10.3390/jcm9092988
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author Park, Yoon Jung
Yang, Pil-Sung
Yu, Hee Tae
Kim, Tae-Hoon
Jang, Eunsun
Uhm, Jae-Sun
Pak, Hui-Nam
Lee, Moon-Hyoung
Lip, Gregory Y.H.
Joung, Boyoung
author_facet Park, Yoon Jung
Yang, Pil-Sung
Yu, Hee Tae
Kim, Tae-Hoon
Jang, Eunsun
Uhm, Jae-Sun
Pak, Hui-Nam
Lee, Moon-Hyoung
Lip, Gregory Y.H.
Joung, Boyoung
author_sort Park, Yoon Jung
collection PubMed
description Intensive blood pressure (BP) lowering in patients with hypertension at increased risk of cardiovascular disease has been associated with a lowered risk of incident atrial fibrillation (AF). It is uncertain whether maintaining the optimal BP levels can prevent AF in the general elderly population. We included 115,866 participants without AF in the Korea National Health Insurance Service-Senior (≥60 years) cohort from 2002 to 2013. We compared the influence of BP on the occurrence of new-onset AF between octogenarians (≥80 years) and non-octogenarians (<80 years) subjects. With up to 6.7 ± 1.7 years of follow-up, 4393 incident AF cases occurred. After multivariable adjustment for potentially confounding clinical covariates, the risk of AF in non-octogenarians was significantly higher in subjects with BP levels of <120/<80 and ≥140/90 mm Hg, with hazard ratios of 1.15 (95% confidence interval (CI), 1.03–1.28; p < 0.001) and 1.14 (95% CI, 1.04–1.26; p < 0.001), compared to the optimal BP levels (120–129/<80 mm Hg). In octogenarians, the optimal BP range was 130–139/80–89 mm Hg, higher than in non-octogenarians. A U-shaped relationship for the development of incident AF was evident in non-octogenarians, and BP levels of 120–129/<80 mm Hg were associated the lowest risk of incident AF. Compared to non-octogenarians, the lowest risk of AF was associated with higher BP levels of 130–139/80–89 mm Hg amongst octogenarians.
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spelling pubmed-75637342020-10-27 What Is the Ideal Blood Pressure Threshold for the Prevention of Atrial Fibrillation in Elderly General Population? Park, Yoon Jung Yang, Pil-Sung Yu, Hee Tae Kim, Tae-Hoon Jang, Eunsun Uhm, Jae-Sun Pak, Hui-Nam Lee, Moon-Hyoung Lip, Gregory Y.H. Joung, Boyoung J Clin Med Article Intensive blood pressure (BP) lowering in patients with hypertension at increased risk of cardiovascular disease has been associated with a lowered risk of incident atrial fibrillation (AF). It is uncertain whether maintaining the optimal BP levels can prevent AF in the general elderly population. We included 115,866 participants without AF in the Korea National Health Insurance Service-Senior (≥60 years) cohort from 2002 to 2013. We compared the influence of BP on the occurrence of new-onset AF between octogenarians (≥80 years) and non-octogenarians (<80 years) subjects. With up to 6.7 ± 1.7 years of follow-up, 4393 incident AF cases occurred. After multivariable adjustment for potentially confounding clinical covariates, the risk of AF in non-octogenarians was significantly higher in subjects with BP levels of <120/<80 and ≥140/90 mm Hg, with hazard ratios of 1.15 (95% confidence interval (CI), 1.03–1.28; p < 0.001) and 1.14 (95% CI, 1.04–1.26; p < 0.001), compared to the optimal BP levels (120–129/<80 mm Hg). In octogenarians, the optimal BP range was 130–139/80–89 mm Hg, higher than in non-octogenarians. A U-shaped relationship for the development of incident AF was evident in non-octogenarians, and BP levels of 120–129/<80 mm Hg were associated the lowest risk of incident AF. Compared to non-octogenarians, the lowest risk of AF was associated with higher BP levels of 130–139/80–89 mm Hg amongst octogenarians. MDPI 2020-09-16 /pmc/articles/PMC7563734/ /pubmed/32947828 http://dx.doi.org/10.3390/jcm9092988 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Park, Yoon Jung
Yang, Pil-Sung
Yu, Hee Tae
Kim, Tae-Hoon
Jang, Eunsun
Uhm, Jae-Sun
Pak, Hui-Nam
Lee, Moon-Hyoung
Lip, Gregory Y.H.
Joung, Boyoung
What Is the Ideal Blood Pressure Threshold for the Prevention of Atrial Fibrillation in Elderly General Population?
title What Is the Ideal Blood Pressure Threshold for the Prevention of Atrial Fibrillation in Elderly General Population?
title_full What Is the Ideal Blood Pressure Threshold for the Prevention of Atrial Fibrillation in Elderly General Population?
title_fullStr What Is the Ideal Blood Pressure Threshold for the Prevention of Atrial Fibrillation in Elderly General Population?
title_full_unstemmed What Is the Ideal Blood Pressure Threshold for the Prevention of Atrial Fibrillation in Elderly General Population?
title_short What Is the Ideal Blood Pressure Threshold for the Prevention of Atrial Fibrillation in Elderly General Population?
title_sort what is the ideal blood pressure threshold for the prevention of atrial fibrillation in elderly general population?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7563734/
https://www.ncbi.nlm.nih.gov/pubmed/32947828
http://dx.doi.org/10.3390/jcm9092988
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