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Clinical Summary

Blood Pressure, Hypertension, and Atrial Fibrillation Risk: What’s the Association?


  • Patients with hypertension had an increased risk of developing atrial fibrillation (AF) compared with those without hypertension.
  • An increase in systolic and diastolic blood pressure (BP) even within the normal range was linked to a higher risk of AF.
  • Patients with higher systolic and diastolic BP had a 2-fold higher risk of AF.

Why This Matters

  • Findings strongly support the role of higher BP in the development of AF.

Study Design

  • This meta-analysis included 68 cohort studies after a search across PubMed and Embase databases.
  • Funding: South-East Regional Health Authority of Norway and others.

Key Results

  • Patients with vs without hypertension had an increased risk of AF (relative risk [RR] 1.50; 95% CI 1.42 to 1.58; I2, 98.1%).
  • The risk of AF was increased with per (RR; 95% CI):
    • 20 mmHg increase in systolic BP (1.19; 1.16 to 1.21; I2, 68.4%); and
    • 10 mmHg increase in diastolic BP (1.06; 1.02 to 1.10; I2, 92.1%).
  • The normal range of systolic and diastolic BP was linked to a higher risk of AF.
  • However, higher systolic and diastolic BP of 180/110 mmHg was associated with an approximately 2-fold increased risk of AF.


  • Heterogeneity among studies.
  • Possible risk of residual confounding.