Incident atrial fibrillation hazard in hypertensive population: a risk function from and for clinical practice.
Determining the risk of atrial fibrillation within the hypertensive population without ischemic vascular disease would aid in decision making on preventive approaches. Accordingly, we aimed to estimate the risk of incident atrial fibrillation in this population. We conducted an historical cohort study between July 1, 2006, and December 31, 2011, using anonymized longitudinal patient information from primary care and hospital discharge records contained in the System for the Development of Research in Primary Care database. We included 255 440 hypertensive patients, aged ≥55 years at the time of study entry. Individuals with previous atrial fibrillation, ischemic heart disease, stroke, and peripheral artery disease were excluded. To build the incident atrial fibrillation risk function, a derivation and a validation cohort were defined, representing 60% and 40% of the entire database, respectively, and a Cox proportional hazards model was fitted. Atrial fibrillation incidence was 7.24 per 1000 person-years (95% confidence interval, 7.08-7.40). The final model included age, weight, total cholesterol, heart failure, valvular heart disease, and antihypertensive treatment. Its concordance index (standard error) was 0.769 (0.004) and 0.768 (0.005) in the derivation and validation datasets, respectively. This research provides a tool, built with variables from daily clinical practice, that can be readily used in the primary care setting to predict atrial fibrillation incidence in the hypertensive population without ischemic vascular disease. The tool may help tailor individualized diagnostic and preventive care decisions.
['Alves-Cabratosa|Lia|L|', 'García-Gil|Maria|M|', 'Comas-Cufí|Marc|M|', 'Ponjoan|Anna|A|', 'Martí|Ruth|R|', 'Parramon|Dídac|D|', 'Blanch|Jordi|J|', 'Ramos|Rafel|R|']
D017677:Age Distribution D000368:Aged D000889:Anti-Arrhythmia Agents D000959:Antihypertensive Agents D001281:Atrial Fibrillation D001795:Blood Pressure Determination D016022:Case-Control Studies D015897:Comorbidity D016001:Confidence Intervals D016208:Databases, Factual D004562:Electrocardiography D005260:Female D006801:Humans D006973:Hypertension D015994:Incidence D016014:Linear Models D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D011379:Prognosis D016016:Proportional Hazards Models D015203:Reproducibility of Results D012189:Retrospective Studies D018570:Risk Assessment D012720:Severity of Illness Index D017678:Sex Distribution
incidence atrial fibrillation hypertension risk aging electronic health records validation studies