Supplemental Digital Content is available in the text. Blood pressure variability is a well-known risk factor for cardiovascular disease, but its association with atrial fibrillation (AF) is uncertain. We aimed to evaluate the association between visit-to-visit blood pressure variability and incident AF. This population-based cohort study used database from the Health Screening Cohort, which contained a complete set of medical claims and a biannual health checkup information of the Koran population. A total of 8 063 922 individuals who had at least 3 health checkups with blood pressure measurement between 2004 and 2010 were collected after excluding subjects with preexisting AF. Blood pressure variability was defined as variability independence of the mean and was divided into 4 quartiles. During a mean follow-up of 6.8 years, 140 086 subjects were newly diagnosed with AF. The highest blood pressure variability (fourth quartile) was associated with an increased risk of AF (hazard ratio, 95% CI; systolic blood pressure: 1.06, 1.05–1.08; diastolic blood pressure: 1.07, 1.05–1.08) compared with the lowest (first quartile). Among subjects in the fourth quartile in both systolic and diastolic blood pressure variability, the risk of AF was 7.6% higher than those in the first quartile. Moreover, this result was consistent in both patients with or without prevalent hypertension. In subgroup analysis, the impact of high blood pressure variability on AF development was stronger in high-risk subjects, who were older (≥65 years), with diabetes mellitus or chronic kidney disease. Our findings demonstrated that higher blood pressure variability was associated with a modestly increased risk of AF.

中文翻译：

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新发房颤的血压变异性和发生率

补充数字内容在文本中可用。血压变异性是众所周知的心血管疾病危险因素，但其与心房颤动 (AF) 的关联尚不确定。我们旨在评估每次就诊的血压变异性与 AF 事件之间的关联。这项基于人群的队列研究使用了健康筛查队列的数据库，该数据库包含一套完整的医疗索赔和可兰经人群的两年一次的健康检查信息。剔除既往房颤患者后，共收集 2004 年至 2010 年间至少进行 3 次血压测量健康检查的个体 8 063 922 人。血压变异性被定义为平均值的变异性独立性，并分为 4 个四分位数。在平均 6.8 年的随访期间，140 086 名受试者新诊断为 AF。最高的血压变异性（第四四分位数）与 AF 风险增加相关（风险比，95% CI；收缩压：1.06、1.05-1.08；舒张压：1.07、1.05-1.08）与最低的（第一个四分位数）。在收缩压和舒张压变异性处于第四四分位数的受试者中，房颤的风险比第一四分位数的受试者高 7.6%。此外，这一结果在有或没有普遍高血压的患者中都是一致的。在亚组分析中，高血压变异性对房颤发展的影响在年龄较大（≥65 岁）、患有糖尿病或慢性肾病的高危受试者中更强。