In a new study from King’s College London, researchers found that high blood pressure is causally linked to the most common heart rhythm disorder.
Atrial fibrillation is the most common heart rhythm disorder, affecting more than 40 million individuals globally. People with the disorder have a five times greater risk of having a stroke.
Previous studies have shown an association between high blood pressure and developing atrial fibrillation, but there was no strong evidence of direct causality.
In the study, the team conducted a naturally randomized controlled trial—called Mendelian randomization.
They used data from the largest genome-wide association study (GWAS) on blood pressure and atrial fibrillation which included more than one million individuals of European ancestry—of which 60,620 had atrial fibrillation and 970,216 did not.
The first step was to identify 894 genetic variants linked to blood pressure. Next, the researchers analyzed which of those variants play a role in atrial fibrillation.
Then the 894 genetic variants were randomly allocated to all participants at conception, giving each individual a blood pressure level.
The team then analyzed the association between blood pressure and atrial fibrillation.
They found elevated blood pressure was associated with an increased risk of atrial fibrillation.
Specifically, 1 mmHg rises in systolic blood pressure, diastolic blood pressure and pulse pressure were associated with 1.8%, 2.6% and 1.4% relative increases in the risk of atrial fibrillation, respectively.
The results provide strong evidence of a causal link between blood pressure and atrial fibrillation.
Using genetic information in the analyses minimizes the likelihood of reverse causality (i.e. that atrial fibrillation causes high blood pressure) or that other trait linked with atrial fibrillation (confounders) were responsible.
The study showed that the link was not driven by other conditions including coronary artery disease and obesity.
This indicates that strict blood pressure control could be an effective strategy to stop atrial fibrillation and its complications, which include stroke, heart failure, dementia, and depression.
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The study is published in the European Journal of Preventive Cardiology. One author of the study is Dr. Georgios Georgiopoulos.
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