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High normal" blood pressure and AF


January 18, 2012 (Oslo, Norway) - a normal level of blood pressure in healthy middle-aged man, the development of high risk prediction in elderly atrial fibrillation, a new study suggests [1].The study was published online on January 17, 2012, high blood pressure, a Swedish group led by Dr. Eileen Grundvold (in Oslo, Norway University Hospital).They recruited the Group from 1972 to 1975 of 2014 healthy middle-aged men, they underwent a comprehensive clinical examination, including blood pressure measurement. Up to 35 years of follow-up period, 270 people were found to have atrial fibrillation. Late development in most of the life conditions, from a baseline average of 20 years of age.Blood pressure after adjustment of other risk factors, a quarter of the development of atrial fibrillation the risk estimates calculated on the basis. The results show that the risk of atrial fibrillation in addition to those men in the baseline blood pressure, and a normal blood pressure levels (systolic blood pressure 128-138 mm Hg) increase is lower than 116 mm Hg baseline pressure and contraction.Baseline blood pressure quartile relative risk of atrial fibrillation than the lowest quartile
A quarterRelative risk (95% CI)1 (88-116 mm Hg)1.02 (118-126 mm Hg)1.26 (0.74-2.14)3 (128-138 mm Hg)1.98 (1.22-3.27)4 (140-220 mm Hg)1.84 (1.07-3.19)

When the systolic blood pressure below 128 mm Hg blood pressure used as a reference, the "high normal" systolic blood pressure (quartile 3) of the AF of 1.5 times the risk, and the pressure of more than 140 mm Hg (interquartile range, 4) 1.6 times the risk.Compared with levels above 80 mm Hg in diastolic blood pressure, 1.79 relative risk for the development of AF value of less than 80 mm Hg.grundvold told heartwire, as far as she knew, this is the first study to show a normal level of blood pressure, atrial fibrillation increased risk of otherwise healthy men, although similar findings in women in women's health study.The mechanisms involved, she said: "I think as a continuous increase in blood pressure levels and hypertension, in my opinion, the mechanism for the establishment of high blood pressure, normal blood pressure similar to a large extent." In the paper, the authorswrote: "With the passage of time may lead to high blood pressure slow and gradual process, one in two ventricular and atrial structural and electrical remodeling increased end-diastolic left ventricular pressure and subsequent increase in left atrial pressure may result in atrial stretch and the final expansion, which may be beneficial to the development of atrial fibrillation. "the grundvold proposal is too early to make any firm clinical recommendations based on these results. "In my opinion, these results add to the understanding of the development of the atrial fibrillation, we need further research to address the impact of drug treatment and treatment goals."In the accompanying Perspective [2], Dr. Paul Verdecchia (Assisi, Italy, hospitals) led a group of stressed AF five times the stroke risk, increased risk of heart failure twice doubling in risk of Alzheimer'sdisease, as well as of all-cause mortality significantly increased risk, "through appropriate control of modifiable risk factor for atrial fibrillation prevention is a public health priority."They added that hypertension is a well-known risk factors modify the AF, it is still unclear exactly what level of blood pressure, the risk began to increase, what the goal should be aimed at reducing risk.It is said that in the current study and the Women's Health Study data has led to the assumption of the measures that could delay the deterioration from prehypertension to hypertension may also prevent the more positive the new AF and hypertensive patients, blood pressure control may also reduce this risk.Although there are some data to support this - from the heart of SIS test and ALLHAT - They call for more data. They concluded that "this is a priority, researchers for further analysis of existing databases and appropriate intervention studies designed to clarify the relationship between BP control strategy and the risk of atrial fibrillation."

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