Over the past 32 years, high body mass index has been the primary contributor to the rising global burden of atrial fibrillation/flutter, with an average annual percentage change in mortality of 1.66.
Observational
From 1990 to 2021, high body mass index became the primary driver of the rising global AF/AFL burden, while the burden associated with smoking showed the greatest decline.
Estimación del efecto: AAPC 1.66 (95% CI 1.63-1.68)
Background: Atrial fibrillation/flutter (AF/AFL) remains a significant global public health issue, with its development influenced by metabolic, behavioral, and environmental risk factors However, comprehensive analyses of temporal and geographic variations in AF/AFL burden attributed to risk factors remain lacking. Objective: This study reveals the geographic and temporal distribution of the burden of AF/AFL attributable to specific risk factors at global, regional, and national levels from 1990 to 2021, providing a scientific basis for developing targeted prevention and control policies. Methods: We extracted data on AF/AFL risk-attributable deaths, disability-adjusted life years (DALYs), age-standardized mortality rates (ASMRs), and age-standardized DALY rates (ASDRs) from the Global Burden of Disease (GBD) database for the years 1990 to 2021. The burden of AF/AFL caused by metabolic, behavioral, and environmental risk factors stratified by age, sex, region, and country. Long-term trends in the AF/AFL burden associated with specific risk factors were assessed using the average annual percentage change (AAPC). Results: Over the past 32 years, high body mass index has been the primary contributor to the rising AF/AFL burden, with AAPCs of ASMR and ASDR at 1.66 (95% CI: 1.63-1.68) and 1.68 (95% CI: 1.67-1.70), respectively. The most significant increase occurred in males aged 30-34. The burden related to high sodium diets and lead exposure is also rising, particularly in females aged 65-69. Smoking showed the greatest decrease, with AAPCs of ASMR and ASDR at -0.66 (95% CI: -0.68 to -0.65) and -0.72 (95% CI: -0.72 to -0.71), most significantly in women aged 30-34. High systolic blood pressure decreased overall, but increased in individuals aged 34-49. East Asia saw the largest increase in burden from high body mass index, with AAPCs of ASMR at 8.28 (95% CI: 8.18-8.37) and ASDR at 8.22 (95% CI: 8.18-8.26). In 2021, China had the highest AF/AFL deaths and DALYs attributed to high systolic blood pressure, high sodium diets, smoking, and lead exposure. Conclusion: From 1990 to 2021, high body mass index became the primary driver of the rising global AF/AFL burden, particularly affecting East Asia and young and middle-aged adults. In contrast, the burden associated with smoking showed the greatest decline. In 2021, China had the highest AF/AFL burden due to various risk factors. Given the regional variations and characteristics of high-risk populations, policymakers should develop targeted yet comprehensive prevention strategies. These measures should include promoting healthy dietary habits, strengthening global surveillance systems, and fostering data-sharing collaborations to mitigate this growing epidemic.
Wei et al. (Thu,) conducted a observational in Atrial fibrillation/flutter. High body mass index was evaluated on Average annual percentage change (AAPC) of age-standardized mortality rate (ASMR) (AAPC 1.66, 95% CI 1.63-1.68). Over the past 32 years, high body mass index has been the primary contributor to the rising global burden of atrial fibrillation/flutter, with an average annual percentage change in mortality of 1.66.