ArticleHypertension (Dallas, Tex. : 1979)2016
Trajectories of Risk Factors and Risk of New-Onset Atrial Fibrillation in the Framingham Heart Study.
Open access · bronzeAbstract readComparative Study
In one paragraph
Article in Hypertension (Dallas, Tex. : 1979), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
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32citing papers in PubMed, 1 pooled it
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The trial behind it
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Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Association of clinic and ambulatory blood pressure with new-onset atrial fibrillation: A meta-analysis of observational studies.Journal of clinical hypertension (Greenwich, Conn.) · 2021Pooled it
- Systolic Blood Pressure and Effects of Screening for Atrial Fibrillation With Long-Term Continuous Monitoring (a LOOP Substudy).Hypertension (Dallas, Tex. : 1979) · 2022Trial
- Sex Differences in the Effect of Long-Term Blood Pressure Trajectories and Variability on the Atrial Fibrillation Risk in a Korean Cohort.Journal of Korean medical science · 2026Article
- Article
- Trajectories of blood pressure measures and the incidence of electrocardiographic abnormalities: a worker-based cohort study.Frontiers in public health · 2026Article
- Klotho G-395A Polymorphism as a Risk Factor for Atrial Fibrillation in Patients on Maintenance Hemodialysis.Advances in urology · 2026Article
- Age-Specific Association Between Cumulative Blood Pressure Exposure and Atrial Fibrillation Risk in Adults.Journal of the American Heart Association · 2025Article
- Trajectories of Lipid Profile Changes and Cardiovascular Outcomes in Elderly Asian Patients With Atrial Fibrillation.Journal of arrhythmia · 2025Article
- Normal Blood Pressure, High Normal Blood Pressure, and Risk of Incident Atrial Fibrillation: A Population-Based Cohort Study.Health science reports · 2025Article
- Integrated Management of Persistent Atrial Fibrillation.Biomedicines · 2025Review
- Advances in Atrial Fibrillation Management: A Guide for General Internists.Journal of clinical medicine · 2024Review
- The role of NT-proBNP in screening for atrial fibrillation in hypertensive disease.International journal of cardiology. Heart & vasculature · 2024Article
- Article
- Association of hypertension severity and control with risk of incident atrial fibrillation: The REasons for Geographic And Racial Differences in Stroke (REGARDS) study.Clinical cardiology · 2023Article
- Long-term blood pressure patterns in midlife and dementia in later life: Findings from the Framingham Heart Study.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- Association of blood pressure trajectories with coronary heart disease among the disabled population in Shanghai, China: a cohort study of 7 years following up.European journal of medical research · 2023Article
- JCS/JHRS 2020 Guideline on Pharmacotherapy of Cardiac Arrhythmias.Journal of arrhythmia · 2022Article
- Prevalence of atrial fibrillation and the risk of cardiovascular mortality among hypertensive elderly population in northeast China.Journal of clinical hypertension (Greenwich, Conn.) · 2022Article
- Relations Between BMI Trajectories and Habitual Physical Activity Measured by a Smartwatch in the Electronic Cohort of the Framingham Heart Study: Cohort Study.JMIR cardio · 2022Article
- Blood pressure trajectories in early adulthood and myocardial structure and function in later life.ESC heart failure · 2022Article
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Faisal RahmanFrom the Department of Medicine, Boston University Medical Center, MA (F.R.); Department of Biostatistics (X.Y., M.G.L.) and Department of Epidemiology (R.S.V., E.J.B.), Boston University School of Public Health, MA; Section of Cardiovascular Medicine, Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, MA (X.Y., R.S.V., E.J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (P.T.E., S.A.L.); National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, MA (X.Y., M.G.L., R.S.V., E.J.B.); Department of Medicine, Cardiology Division, University of Massachusetts Medical School, Worcester (D.D.M.); Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.).
Xiaoyan YinFrom the Department of Medicine, Boston University Medical Center, MA (F.R.); Department of Biostatistics (X.Y., M.G.L.) and Department of Epidemiology (R.S.V., E.J.B.), Boston University School of Public Health, MA; Section of Cardiovascular Medicine, Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, MA (X.Y., R.S.V., E.J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (P.T.E., S.A.L.); National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, MA (X.Y., M.G.L., R.S.V., E.J.B.); Department of Medicine, Cardiology Division, University of Massachusetts Medical School, Worcester (D.D.M.); Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.).
Martin G LarsonFrom the Department of Medicine, Boston University Medical Center, MA (F.R.); Department of Biostatistics (X.Y., M.G.L.) and Department of Epidemiology (R.S.V., E.J.B.), Boston University School of Public Health, MA; Section of Cardiovascular Medicine, Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, MA (X.Y., R.S.V., E.J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (P.T.E., S.A.L.); National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, MA (X.Y., M.G.L., R.S.V., E.J.B.); Department of Medicine, Cardiology Division, University of Massachusetts Medical School, Worcester (D.D.M.); Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.).
Patrick T EllinorFrom the Department of Medicine, Boston University Medical Center, MA (F.R.); Department of Biostatistics (X.Y., M.G.L.) and Department of Epidemiology (R.S.V., E.J.B.), Boston University School of Public Health, MA; Section of Cardiovascular Medicine, Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, MA (X.Y., R.S.V., E.J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (P.T.E., S.A.L.); National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, MA (X.Y., M.G.L., R.S.V., E.J.B.); Department of Medicine, Cardiology Division, University of Massachusetts Medical School, Worcester (D.D.M.); Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.).
Steven A LubitzFrom the Department of Medicine, Boston University Medical Center, MA (F.R.); Department of Biostatistics (X.Y., M.G.L.) and Department of Epidemiology (R.S.V., E.J.B.), Boston University School of Public Health, MA; Section of Cardiovascular Medicine, Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, MA (X.Y., R.S.V., E.J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (P.T.E., S.A.L.); National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, MA (X.Y., M.G.L., R.S.V., E.J.B.); Department of Medicine, Cardiology Division, University of Massachusetts Medical School, Worcester (D.D.M.); Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.).
Ramachandran S VasanFrom the Department of Medicine, Boston University Medical Center, MA (F.R.); Department of Biostatistics (X.Y., M.G.L.) and Department of Epidemiology (R.S.V., E.J.B.), Boston University School of Public Health, MA; Section of Cardiovascular Medicine, Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, MA (X.Y., R.S.V., E.J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (P.T.E., S.A.L.); National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, MA (X.Y., M.G.L., R.S.V., E.J.B.); Department of Medicine, Cardiology Division, University of Massachusetts Medical School, Worcester (D.D.M.); Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.).
David D McManusFrom the Department of Medicine, Boston University Medical Center, MA (F.R.); Department of Biostatistics (X.Y., M.G.L.) and Department of Epidemiology (R.S.V., E.J.B.), Boston University School of Public Health, MA; Section of Cardiovascular Medicine, Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, MA (X.Y., R.S.V., E.J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (P.T.E., S.A.L.); National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, MA (X.Y., M.G.L., R.S.V., E.J.B.); Department of Medicine, Cardiology Division, University of Massachusetts Medical School, Worcester (D.D.M.); Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.).
Jared W MagnaniFrom the Department of Medicine, Boston University Medical Center, MA (F.R.); Department of Biostatistics (X.Y., M.G.L.) and Department of Epidemiology (R.S.V., E.J.B.), Boston University School of Public Health, MA; Section of Cardiovascular Medicine, Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, MA (X.Y., R.S.V., E.J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (P.T.E., S.A.L.); National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, MA (X.Y., M.G.L., R.S.V., E.J.B.); Department of Medicine, Cardiology Division, University of Massachusetts Medical School, Worcester (D.D.M.); Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.).
Emelia J BenjaminFrom the Department of Medicine, Boston University Medical Center, MA (F.R.); Department of Biostatistics (X.Y., M.G.L.) and Department of Epidemiology (R.S.V., E.J.B.), Boston University School of Public Health, MA; Section of Cardiovascular Medicine, Preventive Medicine and Epidemiology, Department of Medicine, Boston University School of Medicine, MA (X.Y., R.S.V., E.J.B.); Cardiovascular Research Center, Massachusetts General Hospital, Charlestown (P.T.E., S.A.L.); National Heart Lung and Blood Institute's and Boston University's Framingham Heart Study, MA (X.Y., M.G.L., R.S.V., E.J.B.); Department of Medicine, Cardiology Division, University of Massachusetts Medical School, Worcester (D.D.M.); Department of Medicine, Division of Cardiology, UPMC Heart & Vascular Institute, University of Pittsburgh, PA (J.W.M.). emelia@bu.edu.
Boston University · USUniversity Medical Center · USBoston Medical Center · USMassachusetts General Hospital · USNational Heart Lung and Blood Institute · USUniversity of Massachusetts Chan Medical School · US
Funding
University of Massachusetts Center for Clinical Science and Translational SupplementUL1TR001453 · NCATS · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI LUZURIAGA, KATHERINE F · 2015 to 2024
$39.0MIDENTIFICATION OF COMMON GENETIC VARIANTS FOR ATRIAL FIBRILLATION AND PR INTERVALR01HL092577 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI BENJAMIN, EMELIA J., ELLINOR, PATRICK THOMAS · 2009 to 2025
$20.6MResearch Training and Education Core (Core D) P50HL120163 · NHLBI · AMERICAN HEART ASSOCIATION · PI ROBERTSON, ROSE MARIE · 2013 to 2017
$20.1MConProject-006U54HL120163 · NHLBI · AMERICAN HEART ASSOCIATION · PI BHATNAGAR, ARUNI, ROBERTSON, ROSE MARIE · 2018 to 2022
$18.8MAFGen Consortium: Atrial Fibrillation Genomics to Functional AnalysesR01HL128914 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI BENJAMIN, EMELIA J., ELLINOR, PATRICK THOMAS · 2015 to 2018
$3.1MDetermining the Role of the Potassium Channel, KCNN3, in Atrial FibrillationR01HL104156 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI ELLINOR, PATRICK THOMAS · 2010 to 2013
$2.1MMentoring in Arrhythmia ResearchK24HL105780 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI ELLINOR, PATRICK THOMAS · 2011 to 2020
$1.2MUniversity of Massachusetts Center for Clinical and Translational ScienceKL2RR031981 · NCRR · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI SULLIVAN, JOHN LEWIS · 2010 to 2011
$1.2MRisk prediction of atrial fibrillation: clinical, biological and genetic markersRC1HL101056 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI ALONSO, ALVARO, BENJAMIN, EMELIA J. · 2009 to 2010
$967kAtrial Fibrillation: Bridging genetic discovery and clinical associationsK23HL114724 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI LUBITZ, STEVEN A · 2013 to 2017
$893kAtrial fibrillation, functional decline, and arrhythmia detection in older adultsR03AG045075 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI MAGNANI, JARED W. · 2013 to 2014
$151kTHE FRAMINGHAM HEART STUDY-N01HC25195-268025195-268025195N01HC025195 · HC · TRUSTEES OF BOSTON UNIVERSITY · PI WOLF, PHILIP A · 2002 to 2006
–Doris Duke Charitable Foundation 2014105Doris Duke Charitable Foundation 2015084NCATS NIH HHS UL1 TR001453NCRR NIH HHS KL2 RR031981NHLBI NIH HHS HHSN268201500001CNHLBI NIH HHS HHSN268201500001INHLBI NIH HHS K23 HL114724NHLBI NIH HHS K24 HL105780NHLBI NIH HHS N01 HC025195NHLBI NIH HHS P50 HL120163NHLBI NIH HHS R01 HL092577NHLBI NIH HHS R01 HL104156NHLBI NIH HHS R01 HL128914NHLBI NIH HHS RC1 HL101056NHLBI NIH HHS U54 HL120163NIA NIH HHS R03 AG045075
Abstract
The associations of long-term patterns of risk factors and the risk of incident atrial fibrillation (AF) are incompletely characterized. Among 4351 Framingham Study participants (mean age 50±11 years at baseline examination, 57% women) from the original and offspring cohorts, we defined longitudinal patterns, referred to as trajectories, of AF risk factors and a composite AF risk score using ≈16 years of data. We used Cox proportional hazards models to examine the association of trajectories to 15-year risk of AF. During follow-up, 719 participants developed AF. Five distinct trajectory groups were identified for systolic blood pressure (BP): groups 1 and 2 (normotensive throughout), group 3 (prehypertensive), group 4 (hypertensive initially with decreasing BP), and group 5 (hypertensive and increasing BP). In multivariable-adjusted analyses, compared with group 1, groups 4 (hazard ratio 2.05; 95% confidence interval 1.24-3.37) and 5 (hazard ratio 1.95; 95% confidence interval 1.08-3.49) were associated with incident AF. Three trajectory groups were identified for antihypertensive treatment. Compared with the group with no treatment throughout, the other 2 groups were associated with increased risk of incident AF. Distinct trajectories for diastolic BP, smoking, diabetes mellitus, and the composite risk score were not associated with increased 15-year risk of AF. Longitudinal trajectories may distinguish how exposures related to AF contribute toward prospective AF risk. Distinct trajectory groups with persistently elevated systolic BP and longer antihypertensive treatment are associated with increased risk of incident AF.
Indexed as
AdultAgedAge DistributionAge of OnsetAntihypertensive AgentsAtrial FibrillationCohort StudiesComorbidityConfidence IntervalsDiabetes MellitusFemaleHumansHypertensionLongitudinal StudiesMaleMiddle AgedAntihypertensive Agentsatrial fibrillationblood pressureepidemiologyrisk factorstrajectories
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