Key result
Changes in cardiovascular risk factors accounted for 10.9% (95% CI -2.4 to 28.6) of the decline in atrial fibrillation incidence in women and 44.7% (95% CI 19.2 to 100.0) of the increase in men.
Why the study?
The study aimed to explore sex-specific time trends in AF incidence and estimate the impact of changes in risk factor levels.
Cohort (n=28,043)
Incident atrial fibrillation rates have decreased in women but followed a reverse U-shape in men, with changes in blood pressure and BMI being major contributing risk factors.
Sex-specific AF trends warrant surveillance; leaves open whether risk factor modification alters incidence.
AIMS: To explore sex-specific time trends in atrial fibrillation (AF) incidence and to estimate the impact of changes in risk factor levels using individual participant-level data from the population-based Tromsø Study 1994-2016. METHODS AND RESULTS: A total of 14 818 women and 13 225 men aged 25 years or older without AF were enrolled in the Tromsø Study between 1994 and 2008 and followed up for incident AF throughout 2016. Poisson regression was used for statistical analyses. During follow-up, age-adjusted AF incidence rates in women decreased from 1.19 to 0.71 per 1000 person-years. In men, AF incidence increased from 1.18 to 2.82 per 1000 person-years in 2004, and then declined to 1.94 per 1000 person-years in 2016. Changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP), body mass index (BMI), physical activity, smoking and alcohol consumption together accounted for 10.9% [95% confidence interval (CI): -2.4 to 28.6] of the AF incidence decline in women and for 44.7% (95% CI: 19.2; 100.0) of the AF incidence increase in men. Reduction in SBP and DBP had the largest contribution to the decrease in AF incidence in women. Increase in BMI had the largest contribution to the increase in AF incidence in men. CONCLUSION: In the population-based Tromsø Study 1994-2016, AF incidence decreased in women and increased following a reverse U-shape in men. Individual changes in SBP and DBP in women and individual changes in BMI in men were the most important risk factors contributing to the AF incidence trends.
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Sharashova et al. (2022) conducted a cohort in Atrial fibrillation (n=28,043). Changes in cardiovascular risk factors (blood pressure, BMI, physical activity, smoking, alcohol) was evaluated on Incident atrial fibrillation. Changes in cardiovascular risk factors accounted for 10.9% (95% CI -2.4 to 28.6) of the decline in atrial fibrillation incidence in women and 44.7% (95% CI 19.2 to 100.0) of the increase in men.
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