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Increased pulse pressure leads to greater pulsatile load on the heart, ventricular hypertrophy, and increased atrial dimensions. The latter may lead to electrical remodeling in the atrium and to the onset of atrial fibrillation (AF), which affects more than 2.3 million adults in the U.S. To assess the association between pulse pressure and AF, the authors conducted a prospective observational study of 5331 Framingham Heart Study participants (median age, 57 years; 53% women) who were followed for a mean of 16 years, ending in 2004.
AF occurred in 13.1% of patients at a median of 12 years after initial pulse pressure measurement. The 20-year cumulative AF incidence rate was 5.6% in patients with initial pulse pressure <40 mm Hg (25th percenti…