Evidence map›Paper›PMID 31771509›Full record

ArticleBMC cardiovascular disorders2019

Association and impact of hypertension defined using the 2017 AHA/ACC guidelines on the risk of atrial fibrillation in The Atherosclerosis Risk in Communities study.

Anas Rattani, J'Neka S Claxton, Mohammed K Ali, Lin Y Chen, Elsayed Z Soliman, Alonso Alvaro

Open access · goldAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cardiovascular disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.5field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 1 country.

Anas RattaniHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
J'Neka S ClaxtonDepartment of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, CNR 3051, Atlanta, GA, 30307, USA.
Mohammed K AliHubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Lin Y ChenCardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
Elsayed Z SolimanEpidemiological Cardiology Research Center, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Alonso AlvaroDepartment of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, CNR 3051, Atlanta, GA, 30307, USA. alvaro.alonso@emory.edu.ORCID 0000-0002-2225-8323
Emory University · USUniversity of Minnesota Medical Center · USWake Forest University · US

Funding

Mentoring in patient-oriented atrial fibrillation and cardiovascular researchK24HL148521 · NHLBI · EMORY UNIVERSITY · PI ALONSO, ALVARO · 2019 to 2023
$593k
American Heart Association-American Stroke Association 16EIA26410001NHLBI NIH HHS HHSN268201700001CNHLBI NIH HHS HHSN268201700001INHLBI NIH HHS HHSN268201700002CNHLBI NIH HHS HHSN268201700002INHLBI NIH HHS HHSN268201700003CNHLBI NIH HHS HHSN268201700003INHLBI NIH HHS HHSN268201700004CNHLBI NIH HHS HHSN268201700004INHLBI NIH HHS HHSN268201700005CNHLBI NIH HHS HHSN268201700005INHLBI NIH HHS K24 HL148521
6 · The paper itself

Abstract

backgroundHypertension is an established risk factor for the development of atrial fibrillation (AF). We evaluated the association and population impact of hypertension, defined using the new 2017 guidelines, on risk of AF.

methodsIn this analysis, we included 14,915 participants in the Atherosclerosis Risk in Communities study without history of AF. Participants underwent blood pressure measurements at baseline and their antihypertensive medication use was assessed. Incident AF was ascertained from study electrocardiograms, hospital records and death certificates. Cox proportional models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of AF among individuals with hypertension based on the JNC7 and 2017 ACC/AHA guidelines. Poisson models were used to obtain risk ratios and calculate population-attributable fractions (PAFs).

resultsWe identified 2891 cases of incident AF during 21.4 years of mean follow-up. Prevalence of hypertension was 34 and 48% under the JNC7 and 2017 ACC/AHA definitions, respectively. HRs (95%CI) of AF in hypertensives versus non-hypertensives were 1.44 (1.32, 1.56) and 1.37 (1.26, 1.48) after multivariable adjustment under the old and new guidelines, respectively. The corresponding PAF (95%CI) using the old and new guidelines were 11% (8, 13%) and 13% (9, 16%), respectively.

conclusionsOverall, our analysis shows that even though the prevalence of hypertension using the new criteria is 40% higher than with the old criteria, this does not translate into meaningful increases in AF attributable to hypertension. These results suggest that prevention or treatment of hypertension based on the new (versus old) guidelines may have limited impact on AF incidence.

Indexed as

Blood PressurePractice Guidelines as TopicAntihypertensive AgentsAtrial FibrillationFemaleHeart RateHumansHypertensionIncidenceMaleMiddle AgedPrevalencePrognosisProspective StudiesRisk AssessmentRisk FactorsAntihypertensive AgentsACC/AHAAtherosclerosis risk in communities studyAtrial fibrillationHypertensionJNC7

Identifiers

PMID31771509
PMCPMC6878648
OpenAlexW2991361271

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.