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Research Article: Bidirectional relationships between increased arterial stiffness and atrial fibrillation

Date Published: 2026-05-28

Abstract:
We investigated the bidirectional relationships between increased arterial stiffness (iAS) and atrial fibrillation (AF) in a cohort study. The current study includes two sub-studies. In the first sub-study, the aim was to study the impact of baseline iAS on new-onset AF, 9,072 participants with iAS were propensity-matched with 18,144 non-iAS participants. In the second sub-study, the aim was to study the impact of AF with incident iAS, 193 participants with AF were propensity-matched with 579 non-AF participants. The cumulative incidence of new-onset AF (or iAS) within each group was calculated using the Kaplan–Meier method, with the log-rank test applied to evaluate differences between groups. The incidence rates of AF (or iAS) were determined by dividing the number of events by 1,000 person-years. Cox proportional hazards models were utilized to assess the influence of iAS on the risk of AF and vice versa. In the first sub-study, during a median follow-up duration of 8.99 years, 96 AF were recorded in the iAS group, whereas 71 new-onset AF were recorded in the non-iAS group. A greater cumulative incidence of new-onset AF was in the iAS group (3.93%) than the non-AF group (2.00%) ( P <?0.001). Cox regression analysis revealed a positive correlation between iAS and AF [hazard ratio (HR): 6.502, 95% confidence interval (CI): 4.402–9.602, P <?0.001)]. In the second sub-study, during a median follow-up duration of 6.49 years, 105 iAS were recorded in the AF group, whereas 273 new-onset iAS were recorded in the non-AF group. A greater cumulative incidence of new-onset iAS was in the AF group (69.31%) than the non-AF group (47.96%) ( P <?0.001). Cox regression analysis revealed an independent association between AF and iAS (HR: 2.261, 95% CI: 1.636–3.126, P <?0.001). Our findings indicate that there is a bidirectional relationship between iAS and AF. We highlight that preventing iAS is crucial for lowering the risk of AF, while also emphasizing that preventing AF is vital for decreasing the risk of iAS.

Introduction:
We investigated the bidirectional relationships between increased arterial stiffness (iAS) and atrial fibrillation (AF) in a cohort study.

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