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Objective:The aim of the current study was to evaluate the effect of antihypertensive treatment on new-onset atrial fibrillation (AF) in relation to the blood pressure level.Design and method:This retrospective longitudinal study is based on the Swedish Primary Care Cardiovascular Database (SPCCD) which consists of a large primary health care cohort of 74751 patients with hypertension. All patients included in SPCCD during 2002 to 2008 without any AF diagnosis at baseline were included in the current study. All participants were followed until 31st December 2008 or until diagnosed with AF. The blood pressure levels of the participants who did not developed AF were compared with those who developed AF.Results:A total of 32193 patients with no AF at baseline and blood pressure registered through the whole follow-up were included in the analysis. During this period 1750 participants (5.4%) developed AF. The participants who developed AF had the last year of the follow-up a mean systolic blood pressure of 151 mmHg compared to 145 mmHg for the rest of the participants. Hence, participants who developed new-onset AF had 5.8 mmHg significantly higher blood pressure (p-value < 0.0001). This difference remained significant even after adjustment for age and number of antihypertensive medicines.Conclusions:The current study demonstrate that development of AF among hypertensive patients is related to higher blood pressure levels regardless antihypertensive treatment. Thus, blood pressure lowering treatment per se seems to have a protective effect on new-onset AF.

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