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

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