The association between self-rated health and risk of atrial fibrillation: a northern Sweden cohort study

Objective The aim of this study was to examine the association between self-rated health (SRH) and risk of atrial fibrillation (AFIB). Methods We performed a cohort study including 104,198 middle-aged participants from the Västerbotten Intervention Programme, northern Sweden 1988–2014. All participants were free of AFIB at inclusion and completed a questionnaire including SRH. Participants were followed from the health examination to diagnosis of AFIB, death, migration or September 5, 2014. Cox regression analysis was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Results Among participants, 26.6% rated their health as very good, 46.6 as good, 20.4% as average, 5.1% as somewhat poor, and 1.4% as poor. In total, 4775 participants were diagnosed with AFIB. In a multivariable model adjusted for cardiovascular risk factors, good (HR 1.13 [95% CI 1.04, 1.22]), average (HR 1.28 [95% CI 1.16, 1.40]), and somewhat poor (HR 1.26 [95% CI 1.09, 1.45]) SRH were associated with increased AFIB risk compared to very good SRH. P -value for trend for increased AFIB risk with worsening SRH was <0.01. A significant interaction between SRH and sex was observed. Conclusions In conclusion, poorer SRH is associated with increased risk of first-time AFIB.