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Orthostatic change in blood pressure and incidence of atrial fibrillation: results from a bi-ethnic population based study.

TitleOrthostatic change in blood pressure and incidence of atrial fibrillation: results from a bi-ethnic population based study.
Publication TypeJournal Article
Year of Publication2013
AuthorsAgarwal SK, Alonso A, Whelton SP, Soliman EZ, Rose KM, Chamberlain AM, Simpson RJ, Coresh JJ
Secondary AuthorsHeiss G
JournalPLoS One
Date Published2013
KeywordsAfrican Americans, Age Factors, Atrial Fibrillation, Blood Pressure, European Continental Ancestry Group, Female, Follow-Up Studies, Humans, Hypotension, Orthostatic, Male, Middle Aged, Risk Factors

BACKGROUND: Autonomic fluctuations are associated with the initiation and possibly maintenance of atrial fibrillation (AF). However, little is known about the relationship between orthostatic blood pressure change, a common manifestation of autonomic dysfunction, and incident AF.

METHODS: We examined whether supine-to-standing changes in systolic blood pressure (SBP) are associated with incident AF in 12,071 African American and white men and women aged 45-64 years, enrolled in the Atherosclerosis Risks in Communities (ARIC) study. Orthostatic hypotension (OH) was defined as a supine-standing drop in SBP by ≥20 mmHg or diastolic blood pressure by ≥10 mmHg. AF cases were identified based on study scheduled 12-lead ECG, hospital discharge ICD codes, and death certificates through 2009.

RESULTS: OH was seen in 603 (5%) at baseline. During an average follow-up of 18.1 years, 1438 (11.9%) study participants developed AF. Incident AF occurred more commonly among those with OH than those without, a rate of 9.3 vs. 6.3 per 1000 person years, (p

CONCLUSIONS: OH is associated with higher AF incidence. Whether interventions that decrease OH can reduce AF risk remains unknown.

Alternate JournalPLoS One
PubMed ID24244409
PubMed Central IDPMC3823988
Grant List55019 / / PHS HHS / United States
55022 / / PHS HHS / United States
55021 / / PHS HHS / United States
55020 / / PHS HHS / United States
55016 / / PHS HHS / United States
T32-HL-007779 / HL / NHLBI NIH HHS / United States
N01-HC-55015 / HC / NHLBI NIH HHS / United States
T32HL007024 / HL / NHLBI NIH HHS / United States
IRC1HL099452-01 / HL / NHLBI NIH HHS / United States
55018 / / PHS HHS / United States