Different Influence of Blood Pressure on New-Onset Atrial Fibrillation in Pre- And Postmenopausal Women: A Nationwide Population-Based Study

Yun Gi Kim, Kyung Do Han, Do Young Kim, Yun Young Choi, Ha Young Choi, Seung Young Roh, Jaemin Shim, Jin-Seok Kim, Jong Il Choi, Young Hoon Kim

Research output: Contribution to journalArticlepeer-review

Abstract

The characteristics of hypertension in pre- and postmenopausal women are different. Hypertension is a known risk factor for new-onset atrial fibrillation (AF), but its interaction with the menopause state is not fully established. We investigated whether menopause influences the adverse impact of high blood pressure on new-onset AF using a nationwide population-based cohort in Korea. People who underwent both a national health check-up and national cancer screening program were included in this study. A total of 3 280 834 women were assessed with 23 781 070 person∗year follow-up data. Menopause was observed in 1 439 161 women. The risk of new-onset AF and blood pressure showed a linear relationship in premenopausal women (P<0.001 for both systolic and diastolic blood pressure). The risk of new-onset AF was increased by 58.8% if systolic blood pressure was ≥160 mm Hg compared with the reference group (100 mm Hg ≤ systolic blood pressure <110 mm Hg; hazard ratio=1.588 [95% CI, 1.383-1.823]) in premenopause group. However, no consistent correlation was observed between blood pressure and the risk of new-onset AF in postmenopausal women. The increased risk of new-onset AF attributable to elevated blood pressure was more pronounced in patients not taking antihypertension medications (P for interaction <0.001). In conclusion, elevated blood pressure, especially systolic blood pressure, was a significant risk factor for new-onset AF in premenopausal women. Postmenopausal women showed a significantly attenuated association between blood pressure and the risk of new-onset AF. Elevated systolic blood pressure had a more profound impact on new-onset AF in women not taking medications for hypertension.

Original languageEnglish
Pages (from-to)1500-1509
Number of pages10
JournalHypertension
DOIs
Publication statusAccepted/In press - 2021

Keywords

  • atrial fibrillation
  • blood pressure
  • hypertension
  • menopause
  • risk factors

ASJC Scopus subject areas

  • Internal Medicine

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