Is there an association between the prevalence of atrial fibrillation and severity and control of hypertension? The REasons for Geographic And Racial Differences in Stroke study.
The association of atrial fibrillation (AF) with the severity and control of hypertension (HTN) remains unclear. We analyzed data from the national biracial cohort of REasons for Geographic And Racial Differences in Stroke study. The AF prevalence ratios were estimated and full multivariable adjustment included demographics, risk factors, medication adherence, HTN duration, and antihypertensive medication classes. Of the 30,018 study participants (8.6% with AF), 4386 had normotension (4.3% with AF), 5916 had prehypertension (4.3 with AF%), 12,294 had controlled HTN (11.2% with AF), 5587 had uncontrolled HTN (8.1% with AF), 547 had controlled apparent treatment-resistant hypertension (aTRH) (19.2% with AF), and 1288 had uncontrolled aTRH (15.5% with AF). Compared with normotension, the AF prevalence ratios for prehypertension, controlled HTN, uncontrolled HTN, controlled aTRH, and uncontrolled aTRH groups in fully adjusted model were 1.01 (95% confidence interval: 0.84, 1.21), 1.42 (1.18, 1.71), 1.37 (1.14, 1.65), 1.17 (0.86, 1.58), and 1.42 (1.10, 1.84), respectively (P < .001). The prevalence of AF was similar among persons with HTN regardless of blood pressure level and antihypertensive treatment resistance.
Division of Cardiovascular Disease, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA. Electronic address: cardiothorax@gmail.com.
Hemal
H
Bhatt
Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
Christopher M
CM
Gamboa
Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA; Division of General Internal Medicine, Weill Cornell Medical College, New York, NY, USA.
Monika M
MM
Safford
Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Elsayad Z
EZ
Soliman
Division of Preventive Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA.
Stephen P
SP
Glasser
D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000453:epidemiology*; D044383:Black People; D001795:Blood Pressure Determination; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D058246:Prehypertension / Q000150:complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D044465:White People
D000959:Antihypertensive Agents
Antihypertensive medications; beta-blockers; blood pressure; treatment-resistant hypertension