{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:38:51Z","timestamp":1791945531818,"version":"4.3.4"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"23","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2021,6,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Heart failure (HF) and atrial fibrillation (AF) are growing in prevalence worldwide. Few studies have assessed to what extent stage 1 hypertension in the 2017 American College of Cardiology\/American Heart Association blood pressure (BP) guidelines is associated with incident HF and AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Analyses were conducted with a nationwide health claims database collected in the JMDC Claims Database between 2005 and 2018 (n=2\u2009196\u2009437; mean age, 44.0\u00b110.9 years; 58.4% men). No participants were taking antihypertensive medication or had a known history of cardiovascular disease. Each participant was categorized as having normal BP (systolic BP &lt;120 mm\u2009Hg and diastolic BP &lt;80 mm\u2009Hg; n=1\u2009155\u2009885), elevated BP (systolic BP 120\u2013129 mm\u2009Hg and diastolic BP &lt;80 mm\u2009Hg; n=337\u2009390), stage 1 hypertension (systolic BP 130\u2013139 mm\u2009Hg or diastolic BP 80\u201389 mm\u2009Hg; n=459\u2009820), or stage 2 hypertension (systolic BP \u2265140 mm\u2009Hg or diastolic BP \u226590 mm\u2009Hg; n=243\u2009342). Using Cox proportional hazards models, we identified associations between BP groups and HF\/AF events. We also calculated the population attributable fractions to estimate the proportion of HF and AF events that would be preventable if participants with stage 1 and stage 2 hypertension were to have normal BP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Over a mean follow-up of 1112\u00b1854 days, 28\u2009056 incident HF and 7774 incident AF events occurred. After multivariable adjustment, hazard ratios for HF and AF events were 1.10 (95% CI, 1.05\u20131.15) and 1.07 (95% CI, 0.99\u20131.17), respectively, for elevated BP; 1.30 (95% CI, 1.26\u20131.35) and 1.21 (95% CI, 1.13\u20131.29), respectively, for stage 1 hypertension; and 2.05 (95% CI, 1.97\u20132.13) and 1.52 (95% CI, 1.41\u20131.64), respectively, for stage 2 hypertension versus normal BP. Population attributable fractions for HF associated with stage 1 and stage 2 hypertension were 6.1% (95% CI, 5.4%\u20136.8%) and 11.9% (95% CI, 11.5%\u201312.4%), respectively. The population attributable fractions for AF associated with stage 1 and stage 2 hypertension were 5.1% (95% CI, 3.4%\u20136.7%) and 7.5% (95% CI, 6.4%\u20138.6%), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Both stage 1 hypertension and stage 2 hypertension were associated with a greater incidence of HF and AF in the general population. The American College of Cardiology\/American Heart Association BP classification system may help identify adults at higher risk for HF and AF events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.120.052624","type":"journal-article","created":{"date-parts":[[2021,4,22]],"date-time":"2021-04-22T14:00:38Z","timestamp":1619100038000},"page":"2244-2253","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":129,"title":["Association of Blood Pressure Classification Using the 2017 American College of Cardiology\/American Heart Association Blood Pressure Guideline With Risk of Heart Failure and Atrial Fibrillation"],"prefix":"10.1161","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2553-6170","authenticated-orcid":true,"given":"Hidehiro","family":"Kaneko","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine (H. Kaneko, H.I., H. Kiriyama, T.K., K.F., N.T., H.M., I.K.), University of Tokyo, Japan."},{"name":"Department of Advanced Cardiology (H. Kaneko, K.F.), University of Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2565-7290","authenticated-orcid":true,"given":"Yuichiro","family":"Yano","sequence":"additional","affiliation":[{"name":"YCU Center for Novel and Exploratory Clinical Trials, Yokohama City University Hospital, Japan (Y.Y.)."},{"name":"Department of Family Medicine and Community Health, Duke University, Durham, NC (Y.Y.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetaka","family":"Itoh","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (H. Kaneko, H.I., H. Kiriyama, T.K., K.F., N.T., H.M., I.K.), University of Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2306-0669","authenticated-orcid":true,"given":"Kojiro","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology and Health Economics, School of Public Health (K.M., H.Y.), University of Tokyo, Japan."},{"name":"Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan (K.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Kiriyama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (H. Kaneko, H.I., H. Kiriyama, T.K., K.F., N.T., H.M., I.K.), University of Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Kamon","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (H. Kaneko, H.I., H. Kiriyama, T.K., K.F., N.T., H.M., I.K.), University of Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhito","family":"Fujiu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (H. Kaneko, H.I., H. Kiriyama, T.K., K.F., N.T., H.M., I.K.), University of Tokyo, Japan."},{"name":"Department of Advanced Cardiology (H. Kaneko, K.F.), University of Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3091-114X","authenticated-orcid":true,"given":"Nobuaki","family":"Michihata","sequence":"additional","affiliation":[{"name":"Department of Health Services Research (N.M., T.J.), University of Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taisuke","family":"Jo","sequence":"additional","affiliation":[{"name":"Department of Health Services Research (N.M., T.J.), University of Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4818-3347","authenticated-orcid":true,"given":"Norifumi","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine (H. Kaneko, H.I., H. 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