High blood pressure (BP) is a risk factor for atrial fibrillation (AF), independent of other confounders, confirming the hypothesis that it is preventable, researchers have confirmed for the first time using genetic data.
Published in the European Journal of Preventive Cardiology the UK co-led study used Mendelian randomisation (MR) to investigate the potential causal association of BP levels with the risk of developing AF.
Genetic variants associated with the BP traits were retrieved from the International Consortium of Blood Pressure-Genome Wide Association Studies (n=299,024). From 901 reported variants, 894 were assessed in a dedicated Genome-Wide Association Study of AF genetics, including >1,000,000 subjects of European ancestry.
The researchers used two-sample MR analyses to examine the potential causal association of systolic BP (SBP) and diastolic BP (DBP) as well as of pulse pressure (PP) with AF.
MR analysis identified a potentially causal association between AF and SBP (OR, 1.018 [95% CI, 1.012-1.024] per 1 mmHg increase; P<.001), DBP (OR, 1.026 [95% CI, 1.016-1.035] per 1 mmHg increase; P<.001) and PP (OR, 1.014 [95% CI, 1.001-1.028] per 1 mmHg increase; P=.033). These findings were robust in sensitivity analyses, including the MR-Egger method and the MR pleiotropy residual sum and outlier test.
The causal relationship of BP and AF did not change when single-nucleotide polymorphisms associated with possible confounders (i.e. coronary artery disease and obesity) of the causal relationship were excluded.
The researchers concluded that as the association between increased BP levels and the risk of AF is likely causal and applies for different BP indices independently from other risk factors, optimal BP control might represent an important therapeutic target for AF prevention in the general population.
Lead author Dr Georgios Georgiopoulossaid: "This might have a substantial impact on public health, considering the debilitating diseases commonly associated with the development of atrial fibrillation, which include stroke, heart failure, dementia, and depression."
