title: Interaction of Blood Pressure and Body Mass Index With Risk of Incident Atrial Fibrillation in a Japanese Urban Cohort: The Suita Study.
abstract: OBJECTIVE
  To prevent stroke, strategies for atrial fibrillation (AF) prevention and an early detection of AF by electrocardiogram are essential. However, only a limited prospective studies have examined the risk factors for AF, even in blood pressure (BP) and body mass index (BMI), which are not clear among general populations. We investigated the impacts of BP and BMI on the risk of incident AF in a general population.
  
  
  METHODS
  A total of 6,906 participants (30-84 years) in the Suita Study were prospectively followed up for incident AF. Participants were diagnosed with AF if AF or atrial flutter was present on an electrocardiogram from a routine health examination (every 2 years) or if AF was indicated as a present illness from health examinations and/or medical records during follow-up. Adjusted Cox proportional hazard ratios (HRs) were calculated.
  
  
  RESULTS
  During the 12.8-year follow-up, 253 incident AF events occurred. Compared with the systolic BP (SBP) < 120 mm Hg and normal-weight, the adjusted HRs (95% confidence intervals; CIs) of incident AF in the systolic hypertension and the overweight (BMI ≥ 25kg/m(2)) groups were 1.74 (1.22-2.49) and 1.35 (1.01-1.80), respectively. Compared with SBP < 120 mm Hg and normal weight, the adjusted HRs (95% CIs) of incident AF in the SBP = 120-139 mm Hg with overweight and the systolic hypertension with normal or overweight were 1.72 (1.01-2.91), 1.66 (1.10-2.50), and 2.31 (1.47-3.65), respectively (P for interaction = 0.04).
  
  
  CONCLUSIONS
  Systolic prehypertension and overweight are associated with incident AF in Japanese population. The association between SBP and AF may be evident by overweight.
authors.affiliation: Department of Preventive Cardiology, National Cardiovascular Center, Suita, Japan; ykokubo@hsp.ncvc.go.jp.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kokubo
authors.affiliation: Department of Preventive Cardiology, National Cardiovascular Center, Suita, Japan;
authors.forename: Makoto
authors.initials: M
authors.lastname: Watanabe
authors.affiliation: Department of Preventive Medicine and Epidemiologic Informatics, National Cardiovascular Center, Suita, Japan;
authors.forename: Aya
authors.initials: A
authors.lastname: Higashiyama
authors.affiliation: Department of Preventive Cardiology, National Cardiovascular Center, Suita, Japan; Department of Preventive Medicine and Epidemiologic Informatics, National Cardiovascular Center, Suita, Japan;
authors.forename: Yoko M
authors.initials: YM
authors.lastname: Nakao
authors.affiliation: Department of Preventive Cardiology, National Cardiovascular Center, Suita, Japan;
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Preventive Cardiology, National Cardiovascular Center, Suita, Japan;
authors.forename: Takuya
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Preventive Cardiology, National Cardiovascular Center, Suita, Japan; Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan;
authors.forename: Tomonori
authors.initials: T
authors.lastname: Okamura
authors.affiliation: Department of Preventive Cardiology, National Cardiovascular Center, Suita, Japan; The First Institute for Health Promotion and Health Care, Anti-tuberculosis Association, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Okayama
authors.affiliation: Department of Preventive Cardiology, National Cardiovascular Center, Suita, Japan; Department of Preventive Medicine and Epidemiologic Informatics, National Cardiovascular Center, Suita, Japan;
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000453:epidemiology; D001795:Blood Pressure Determination / Q000379:methods; D015992:Body Mass Index; D015331:Cohort Studies; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
keywords: atrial fibrillation; blood pressure; body mass index; hypertension; prospective cohort study; risk factor.