Objective: Atrial fibrillation (AF) is the most common tachyarrhythmia and is a strong risk factor for stroke. However, few prospective studies have examined the relation between a parental history of hypertension and the incidence of AF in a general population. We assessed the hypothesis that a parental history of hypertension is associated with an increased risk of incident AF in an urban general population in Japan.
Methods: A total of 6,918 participants (30~84 years old) initially free of AF were prospectively followed up for incident AF in the Suita Study. Standard 12-lead electrocardiograms were obtained from all subjects in the supine position. Each record was coded independently by 2 well-trained physicians using the Minnesota Code. Participants were diagnosed with AF if AF or atrial flutter was present on electrocardiograms obtained during a biannual routine health examination or if AF was indicated as a present illness by questionnaires responses or by medical records. Well-trained nurses obtained information on parental history of hypertension and lifestyle. Blood pressures (BP) were taken as the average of the second and third measurements. BP categories were defined by the following criteria: normal BP (<120/80 mm Hg), prehypertension (120~139/80~89 mm Hg), and hypertension (>140/90 mm Hg and/or antihypertensive drug user). Cox proportional hazard ratios (HRs) and 95% confidence intervals (CIs) were analyzed after adjusting for age, sex, body mass index, diabetes, hyperlipidemia, smoking, and drinking at baseline.
Results: In 87,164 person-years of follow-up, 244 incident AF events occurred. The adjusted HRs (95% CIs) of incident AF were 1.56 (1.09~2.24) for hypertension and 1.48 (1.02~2.14) for a maternal history of hypertension. Compared with normal BP and non-maternal history of hypertension, the adjusted HRs (95% CIs) of incident AF were 1.61 (1.10~2.35) for hypertension without a maternal history of hypertension, and 2.29 (1.19~4.40) and 1.95 (1.08~3.50) for prehypertension and hypertension with a maternal history of hypertension, respectively.
Conclusions: A maternal history of hypertension is a predictor of incident AF. For persons with a maternal history of hypertension, BP control would be under normal BP for AF prevention.