Chang TIH, et al. - Among older patients initiating hemodialysis, researchers assessed incident atrial fibrillation in relation to predialysis systolic and diastolic BP and intradialytic hypotension in this observational study. To identify patients, they linked the US Renal Data System to the records of a large dialysis provider. They reported the development of atrial fibrillation in 3,785 of 17,003 patients included in this study. On comparing predialysis systolic BP to a fixed reference of 140 mm Hg, a link between lower predialysis systolic BP and a higher hazard of atrial fibrillation was evident and higher systolic BP was related to a lower hazard of atrial fibrillation. A weak association of intradialytic hypotension with atrial fibrillation was found. Overall, a higher incidence of atrial fibrillation was reported in relation to lower predialysis systolic BP and diastolic BP.