Objective:

To evaluate the impact of history of hypertension and specific blood pressure parameters (systolic and diastolic) on cognitive impairment in patients with atrial fibrillation (AF).

Key Findings:

• History of hypertension is associated with increased risk of cognitive impairment in AF patients (OR: 2.22, 95% CI: 2.15–2.30).
• History of hypertension may increase the risk of mild cognitive impairment (OR: 2.06, 95% CI: 1.10–3.85) and dementia (OR: 4.88, 95% CI: 1.29–18.45).
• High-normal blood pressure levels (130-139/85-89 mmHg) are significantly associated with cognitive impairment (HR: 1.07, 95% CI: 1.01–1.13).

Interpretation:

The findings indicate that history of hypertension and high-normal blood pressure levels are significantly associated with cognitive impairment in patients with AF, highlighting the need for clinical interventions.

Limitations:

• Potential confounding factors such as hemodynamic disturbances and anticoagulant use may impact the results.
• Heterogeneity in effect indicators between study designs could affect the reliability of the findings.

Conclusion:

Identifying and intervening in modifiable risk factors like hypertension is crucial for the prevention and treatment of cognitive impairment in AF patients.