title: Diabetes and new-onset atrial fibrillation in a hypertensive population.
abstract: OBJECTIVE
  The association of diabetes with new-onset atrial fibrillation (AF) remains controversial. Hypertension may partly explain the risk association ascribed to diabetes. We studied the role and characteristics of diabetes in hypertensive patients with no ischemic vascular disease.
  
  
  METHODS
  Records of 262,892 persons from the Information System for the Development of Research in Primary Care in Catalonia (Spain) were examined from July 2006 to December 2011. Included participants were ≥55-years-old and hypertensive with no ischemic heart disease, stroke, or peripheral artery disease. We used Cox proportional hazards regression to model incidences in the diabetic and non-diabetic subgroups of our population, and among diabetic patients, diabetes duration and pharmacological treatment, hemoglobin A1C, and body mass index.
  
  
  RESULTS
  New-onset AF incidence in diabetic patients was 13.3 per 1000 person-years (mean follow-up: 4.3 years). In non-diabetic patients, it was 10.4 per 1000 person-years (mean follow-up: 4.1 years). Diabetes hazard ratio (HR) for new-onset AF was 1.11 (95% confidence interval (CI): 1.06-1.16). Diabetic patients also diagnosed with obesity had an HR of 1.41 (95% CI: 1.22-1.64).
  
  
  CONCLUSIONS
  Diabetes was modestly associated with new-onset AF in hypertensive patients with no ischemic vascular disease. Among diabetic patients, only obesity reached significance in its association with this arrhythmia.
authors.affiliation: a Vascular Health Research Group (ISV)-Girona, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol) , Catalonia , Spain ;
authors.forename: Lia
authors.initials: L
authors.lastname: Alves-Cabratosa
authors.affiliation: a Vascular Health Research Group (ISV)-Girona, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol) , Catalonia , Spain ;|b Translab Research Group, Department of Medical Sciences , School of Medicine, University of Girona , Girona , Spain ;
authors.forename: Maria
authors.initials: M
authors.lastname: García-Gil
authors.affiliation: a Vascular Health Research Group (ISV)-Girona, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol) , Catalonia , Spain ;
authors.forename: Marc
authors.initials: M
authors.lastname: Comas-Cufí
authors.affiliation: a Vascular Health Research Group (ISV)-Girona, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol) , Catalonia , Spain ;|c Girona Biomedical Research Institute (IdibGi), Dr. Trueta University Hospital , Catalonia , Spain ;
authors.forename: Ruth
authors.initials: R
authors.lastname: Martí
authors.affiliation: a Vascular Health Research Group (ISV)-Girona, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol) , Catalonia , Spain ;|c Girona Biomedical Research Institute (IdibGi), Dr. Trueta University Hospital , Catalonia , Spain ;
authors.forename: Anna
authors.initials: A
authors.lastname: Ponjoan
authors.affiliation: a Vascular Health Research Group (ISV)-Girona, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol) , Catalonia , Spain ;|d Primary Care Services, Girona, Catalan Institute of Health (ICS) , Catalonia , Spain.
authors.forename: Dídac
authors.initials: D
authors.lastname: Parramon
authors.affiliation: a Vascular Health Research Group (ISV)-Girona, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol) , Catalonia , Spain ;
authors.forename: Jordi
authors.initials: J
authors.lastname: Blanch
authors.affiliation: a Vascular Health Research Group (ISV)-Girona, Jordi Gol Institute for Primary Care Research (IDIAP Jordi Gol) , Catalonia , Spain ;|b Translab Research Group, Department of Medical Sciences , School of Medicine, University of Girona , Girona , Spain ;|d Primary Care Services, Girona, Catalan Institute of Health (ICS) , Catalonia , Spain.
authors.forename: Rafel
authors.initials: R
authors.lastname: Ramos
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology; D015992:Body Mass Index; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000453:epidemiology*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents
keywords: Atrial fibrillation; diabetes; hypertension