Lee SR, Han KD, Choi EK, et al. - Even among young adults, the risk of new-onset atrial fibrillation (AF) was the lowest in relation to optimal blood pressure (BP) control, including diastolic BP.

• This study used a Korean nationwide health screening database to select 2,958,544 individuals aged 20 to 39 years who were not prescribed antihypertensive medication at the index examination in 2009.

• Using the 2017 American College of Cardiology/American Heart Association BP guidelines, 8 groups were defined: normal BP, elevated BP, stage 1 isolated diastolic hypertension (IDH), stage 1 isolated systolic hypertension (ISH), stage 1 systolic-diastolic hypertension (SDH), stage 2 IDH, stage 2 ISH, and stage 2 SDH.

• Relative to normal BP, stage 1 IDH (adjusted hazard ratio, 1.160) and stage 1 SDH (1.250) were found to be related to higher risks of incident AF, but not stage 1 ISH.

• Higher risks of incident AF by 24%, 37%, and 61% were reported in relation to stage 2 IDH, ISH, and SDH, respectively.

• Higher risks of incident AF were noted with stage 1 IDH and SDH vs normal BP.

• Incident AF risk with stage 2 IDH was noted to be similar to that of stage 1 SDH.