Palpitations and hypertension are strong predictors for atrial fibrillation (AF), report researchers.

While hypertension is a well known risk factor for AF, “the impact of self-reported palpitations on later occurrence of AF has not been documented earlier,” they say.

To examine the impact of palpitations and cardiovascular risk factors in the prediction of AF, the researchers examined data from 22,815 individuals who had participated in a population survey between 1994 and 1995. Mean age at baseline was 46 years.

All participants had provided measurements of height, weight, blood pressure, heart rate, total cholesterol, and high-density lipoprotein cholesterol at baseline. Information on palpitations, diabetes, angina, myocardial infarction, and antihypertensive treatment was also available.

The outcome measure was first ever AF, documented on an electrocardiogram.

The researchers identified 361 women (3.0 %) and 461 men (4.2 %) with incident AF over a mean follow-up of 11.1 years.

Compared with men and women who reported no palpitations at baseline, those who reported palpitations had a 91 % and 62 % increased risk for future AF, respectively.

Audhild Nyrnes, from the University of Tromsø in Norway, and team also examined predictors for palpitations and AF separately, in order to exclude any common overlapping risk factors.

For palpitations, but not AF, several significant risk factors were related to lifestyle. By contrast, the most prominent risk factors for AF were biological factors such as age, blood pressure, height, body mass index, and for women diabetes. Height, antihypertensive treatment, and coronary heart disease were risk factors for both palpitations and AF.

“We therefore conclude that palpitations are probably causally associated with atrial fibrillation, but caused by other factors than those predicting AF,” write Nyrnes et al. in the European Journal of Preventive Cardiology.

Hypertension (defined as systolic blood pressure ≥140 mmHg or diastolic blood pressure ≥90 mmHg) was also associated with a 40 % increased risk for incident AF in men and a 98 % increased risk in women.

The researchers conclude that, because individuals with palpitations could have paroxysms of AF, they should be investigated further, with prolonged ECG monitoring.

By Nikki Withers