Accumulated hypertension burden in diabetes patients linked to Increased Atrial Fibrillation risk

Republic of Korea: A new study found that there was an increased risk of incident atrial fibrillation in diabetic patients with the burden of Accumulated hypertension. The study results were published in the journal Cardiovascular Diabetology. 

The cumulative effect of Diabetes and hypertension is associated with an increased risk of atrial fibrillation that in turn increases the risk of morbidity and mortality. The effect of accumulated hypertension burden as a modifiable risk factor is not well-known. As there is an increased risk of incident atrial fibrillation (AF) in patients with diabetes mellitus, researchers explored the relationship between accumulated hypertension burden and incident AF in these patients. 

Data of nearly 5,26,384 patients with diabetes who underwent three consecutive health examinations, between 2009 and 2012, from the Korean National Health Insurance Service evaluated. Each stage of hypertension was assigned pints and the burden was calculated in each health examination. They were assigned as 1 for stage 1 hypertension with systolic blood pressure [SBP] 130–139 mmHg; diastolic blood pressure [DBP] 80–89 mmHg; 2 for stage 2 with SBP 140–159 mmHg and DBP 90–99 mmHg; and 3 for stage 3 with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg. All the participants were divided into 10 hypertensive burden groups (0–9) and clustering was done for Groups 1–9 into 1–3, 4–6, and 7–9. 

Key findings: 

• AF was newly diagnosed in 18,561 (3.5%) patients, during a mean follow-up duration of 6.7 ± 1.7 years. 
• Patients with burdens 1 to 9 showed a progressively increasing risk of incident AF: 6%, 11%, 16%, 24%, 28%, 41%, 46%, 57%, and 67% respectively when compared to patients with hypertension burden 0. 
• Clusters 1–3, 4–6, and 7–9 showed increased risks by 10%, 26%, and 45%, respectively, when compared to a hypertension burden of 0.  

Thus, the study found that patients with DM with a higher accumulated hypertension burden had an increased risk of incident AF, and a positive correlation was found with the risk of AF in diabetics, regardless of the severity of diabetes. 

Further reading: Choi, J., Lee, S., Choi, E., et al. Accumulated hypertension burden on atrial fibrillation risk in diabetes mellitus: a nationwide population study. Cardiovasc Diabetol 22, 12 (2023). https://doi.org/10.1186/s12933-023-01736-4