Sustained pre–hypertensive blood pressure and incident atrial fibrillation: the Multi–Ethnic Study of Atherosclerosis

The association between sustained pre–hypertension and atrial fibrillation (AF) has not been thoroughly examined. This study included 5311 participants (mean age 62 ± 10 years; 47% male; 42.9% non–whites) from the Multi–Ethnic Study of Atherosclerosis. Sustained exposure was based on 2 or more visits within the same blood pressure category (optimal, <120/80 mm Hg; pre–hypertension, 120–139/80–89 mm Hg; hypertension, ≥140/90 mm Hg or antihypertensive medication use) during visits 1, 2, and 3. Cox regression was used to compute hazard ratios (HR) and 95% confidence intervals (CI) for the association between blood pressure category and AF. Over a median follow–up of 5.3 years, 182 (3.4%) participants developed AF. Pre–hypertension and hypertension were associated with an increased risk of AF compared with participants who had optimal blood pressure (optimal: HR, 1.0; referent; pre–hypertension: HR, 1.8; 95% CI, 1.004–3.2; hypertension: HR, 2.6; 95% CI, 1.6–4.4). Sustained pre–hypertension is associated with an increased risk of AF.