Clinical Electrophysiology -> Atrial Fibrillation & Atrial Flutter: -> Physiology D-PO03 - Poster Session III (ID 48) Poster

D-PO03-207 - Effect Of Systolic Blood Pressure On Subsequent Dementia In Patients With And Without Atrial Fibrillation: A Nationwide Cohort Study (ID 1161)


Background: There has been increasing evidence that atrial fibrillation (AF) and blood pressure may contribute to the development of cognitive dysfunction and dementia.
Objective: In this study, we sought to assess the effects of AF and blood pressure on the development of dementia in different age subgroups.
Methods: From the National Health Insurance Service-Health Screening cohort in Korea, 428,976 subjects (14,784 patients with and 414,192 without AF) aged 40-79 years and who had no previous diagnosis of dementia or stroke were followed from initial blood pressure measurement until dementia, death, or December 31, 2013.
Results: A total of 9,435 dementia events was observed during a mean follow-up duration of 87.9 ± 17.4 months. Compared with patients without AF, patients with AF had significantly increased risk of dementia [adjusted hazard ratio (aHR) 1.59, 95% confidence interval (CI ) 1.48-1.71]. Even after censoring for stroke, AF was consistently associated with increased risk of dementia. In patients aged 40-59, increased baseline SBP ≥140 mmHg was associated with increased risk of dementia in both patients with (aHR 2.24, 95% CI 1.15-4.37) and without AF (aHR 2.01, 95% CI 1.64-2.45). No significant associations were seen in AF patients aged >60 years. In patients with baseline SBP ≥140 mmHg, optimal follow-up SBP (120-129 mmHg) was associated with lower risk of dementia compared with follow-up SBP ≥140 mmHg (continuously uncontrolled) (HR 0.70, 95% CI 0.53-0.93).
Conclusion: Increased SBP were associated with increased risk of dementia in both patients with and without AF. Adequate blood pressure control of SBP 120-129 mmHg prevented the development of dementia.