Absolute and Attributable Risks of Atrial Fibrillation in Relation to Optimal and Borderline Risk Factors: the Atherosclerosis Risk in Communities (ARIC) Study
By R. Huxley, Faye L. Lopez, A. Folsom, S. Agarwal, L. Loehr, E. Soliman, R. Maclehose, Suma H Konety, Á. Alonso. Circulation, 2011
600 citations recorded by the source corpus.
Background— Atrial fibrillation (AF) is an important risk factor for stroke and overall mortality, but information about the preventable burden of AF is lacking. The aim of this study was to determine what proportion of the burden of AF in blacks and whites could theoretically be avoided by the maintenance of an optimal risk profile. Methods and Results— This study included 14 598 middle-aged Atherosclerosis Risk in Communities (ARIC) Study cohort members. Previously established AF risk factors, namely high blood pressure, elevated body mass index, diabetes mellitus, cigarette smoking, and prior cardiac disease, were categorized into optimal, borderline, and elevated levels. On the basis of their risk factor levels, individuals were classified into 1 of these 3 groups. The population-attributable fraction of AF resulting from having a nonoptimal risk profile was estimated separately for black and white men and women. During a mean follow-up of 17.1 years, 1520 cases of incident AF were identified. The age-adjusted incidence rates were highest in white men and lowest in black women (7.45 and 3.67 per 1000 person-years, respectively). The overall prevalence of an optimal risk profile was 5.4% but varied according to race and gender: 10% in white women versus 1.6% in black men. Overall, 56.5% of AF cases could be explained by having ≥1 borderline or elevated risk factors, of which elevated blood pressure was the most important contributor. Conclusion— As with other forms of cardiovascular disease, more than half of the AF burden is potentially avoidable through the optimization of cardiovascular risk factors levels.
Subfields: Cardiology and Cardiovascular Medicine, Epidemiology
View Paper: https://www.semanticscholar.org/paper/06ffadc01454d0b3ba7b150488bc26ef253f915e
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In Cardiology and Cardiovascular Medicine
Citations in the corpus
- 2017 HRS/EHRA/ECAS/APHRS/SOLAECE expert consensus statement on catheter and surgical ablation of atrial fibrillation (2017, background): “Conversely, patients with pharmacologically controlled hypertension could have similar risk of AF recurrence postablation as those without hypertension.(279)”
- EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies: definition, characterization, and clinical implication. (2016, unknown): “Hypertension Hypertension accounts for at least one in five incident AF cases.(170)”
- Atrial fibrillation: profile and burden of an evolving epidemic in the 21st century. (2013, background): “CKD is also a common co-morbidity found in combinationwith AF and, regardless of severity, is associatedwith an increase in the prevalence of AF [85].”