Arrhythmias & electrophysiologyMeta-analysis
Non-linear associations between blood pressure and clinical outcomes in atrial fibrillation: A systematic review and dose-response meta-analysis
- Systematic review and dose-response meta-analysis
- two-stage dose-response meta-analysis
- restricted cubic splines
Authors' conclusion
Systolic blood pressure exhibits a U-shaped relationship with all-cause mortality in patients with AF, balancing against a monotonic increase in ischemic stroke and intracranial haemorrhage at higher pressures.
Study context
- Population
- Individuals with atrial fibrillation (AF), studies reporting outcomes stratified by systolic blood pressure (SBP) and diastolic blood pressure (DBP)23 studies (17 cohorts)
- Participants
- 476,750 individuals
- Comparison
- SBP and DBP levels in AF
- Outcome
- Ischaemic stroke, all-cause mortality and intracranial haemorrhage by SBP and DBP (dose-response)
Pooled result
As reported in the abstract
Dose-response of SBP and DBP with all-cause mortality
SBP: U-shaped association with all-cause mortality, lowest risk at 134 mmHg (RR vs 120 mmHg; CI level not printed)
RR 0.92, 0.86-0.98
DBP: J-shaped association with all-cause mortality, lowest risk at 83 mmHg
RR 0.99, 0.97-1.02
Original publication
Non-linear associations between blood pressure and clinical outcomes in atrial fibrillation: A systematic review and dose-response meta-analysis. Europace. Published 28 August 2026. doi:10.1093/europace/euag223
Summarised from the published abstract; every number is checked against it