High pulse pressure flags cardiac risk

Elevated pulse pressure—the change in BP during cardiac contractions—is an important, independent risk factor for atrial fibrillation (AF), new data show.

Gary F. Mitchell, MD, at Cardiovascular Engineering, Inc., in Waltham, Mass., and his colleagues analyzed data from 5,331 Framingham Heart Study participants (mean age, 57; 55% women) who were AF-free at baseline. During a mean follow-up of 16 years, 698 participants (13.1%) developed cardiologist-confirmed AF a median of 12 years after assessment.

The cumulative 20-year AF incidence rates were 5.6% among participants with pulse pressure below the 25th percentile and 23.3% among participants with pressure above the 75th percentile. In other words, the highest pulse pressure group was at a fourfold increased AF risk compared with the lowest pressure group.

The authors of the study conclude that “in light of the variable and often substantial increase in pulse pressure that accompanies advancing age, lifestyle modifications or therapy aimed specifically at reducing or limiting the increase in pulse pressure with advancing age may markedly reduce the substantial and rapidly growing incidence of AF in our aging society” (JAMA. 2007; 297:709-715).

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