Intensive blood pressure control reduces AF risk, finds study

Hypertension and atrial fibrillation (AF) are two important public health priorities. Their prevalence is increasing worldwide, and both often coexist in the same patient.

Researchers at Wake Forest School of Medicine have found that intensive blood pressure control may reduce the risk of atrial fibrillation (AFib). They found that lowering a systolic blood pressure to less than 120 resulted in a 26% lower risk of AFib compared to systolic blood pressure of less than 140.

The study has been published in the American Heart Association journal Hypertension.

"This is the first evidence from a randomized controlled trial that showed benefit in reducing the risk of atrial fibrillation as a result of aggressive blood pressure control to a target of less than 120 mm Hg," said the study's lead author, Elsayed Z. Soliman, M.D., professor of epidemiology and prevention at Wake Forest School of Medicine, part of Wake Forest Baptist Health.

This analysis, using data from the National Institutes of Health Systolic Blood Pressure (SPRINT) trial, included 8,022 study participants who were randomized into one of two groups: 4,003 participants in an intensive blood pressure control group (target less than 120 mm Hg) and 4,019 participants in a standard lowering group (target less than 140 mm Hg).

Participants were followed for up to five years. During that time, only 88 AFib cases occurred in the intensive blood pressure lowering group while 118 cases occurred in the standard blood pressure lowering group. Soliman's team showed that the benefit of intensive blood pressure lowering on reducing the risk of AFib was similar in all groups of the participants regardless of sex, race or levels of blood pressure.

"Hypertension is the most common modifiable risk factor for atrial fibrillation," Soliman said. "And now, we have a potential pathway for prevention."

The landmark SPRINT study, which published its main results in 2015, enrolled participants with hypertension who were at increased risk of cardiovascular disease. The trial was designed to answer how aggressive blood pressure control affects cardiovascular health and showed that intensive treatment significantly reduced the rates of death and cardiovascular disease. As a result of the trial, the American Heart Association and American College of Cardiology updated their clinical guidelines for high blood pressure.

Previous SPRINT findings published by Wake Forest Baptist researchers have shown that lowering blood pressure reduces risk of cognitive impairment and may slow age-related brain damage.