Atrial fibrillation is associated with cardiovascular events in obese Japanese with one or more cardiovascular risk factors: The Japan Morning Surge Home Blood Pressure (J-HOP) Study

The impacts of atrial fibrillation (AF) and home blood pressure (BP) on the cardiovascular prognosis of obese individuals have not been clarified. We analyzed the differences in the prognosis (including the effect of the home BP of AF patients with/without obesity) in a Japanese population with cardiovascular risk factors. We enrolled 3,586 patients from the J-HOP study who had at least one cardiovascular risk factor. We conducted 12-lead electrocardiography, and the group of AF patients was determined as those whose electrocardiography revealed AF. Obesity was defined as a body mass index >25 kg/m(2). The primary end points were fatal/nonfatal cardiovascular events (myocardial infarction, stroke, hospitalization for heart failure, and aortic dissection). Among the obese patients, those with AF (n = 36) suffered more significantly cardiovascular events (log rank 7.17, p = .007) compared to the patients with sinus rhythm (n = 1,282), but among the non-obese patients, the rates of cardiovascular events were similar (log rank 0.006, p = .94) in the AF patients (n = 48) and sinus rhythm patients (n = 2220). After adjusting for age, sex, office/home BP, smoking, diabetes, and creatinine level, AF was an independent predictor of cardiovascular events in the obese group (hazard ratio [HR] 3.05, 95%CI: 1.17-7.97, p = .023). Home systolic BP was also a predictor of cardiovascular events in the obese group independent of the risk of AF (per 10 mm Hg: HR 1.36, 95%CI: 1.02-1.83, p = .039). In conclusion, AF was an independent predictor of cardiovascular events in obese patients after adjusting for home BP.

Automated summary

In obese patients, atrial fibrillation was found to be an independent predictor of cardiovascular events after adjusting for home blood pressure. Among non-obese individuals, there was no significant difference in cardiovascular event rates between atrial fibrillation patients and those with sinus rhythm. Additionally, home systolic blood pressure was also identified as a predictor of cardiovascular events in obese patients independent of atrial fibrillation risk.