Abstract 15578: Adiposity, Systolic Blood Pressure, Smoking and Atrial Fibrillation: Analyses of 2.3 Million US Adults Attending Cardiovascular Screening
Aims: Unlike other vascular conditions, and for reasons that are incompletely understood, the prevalence of atrial fibrillation (AF) is rising sharply. Analysis of a large healthy cohort which was screened for AF allows reliable assessment of its association with several classical vascular risk factors.
Methods: Between 2009 and 2013, around 3 million US adults attended cardiovascular screening clinics and had an ECG to identify AF. Personal and family medical history, medication use, smoking and alcohol consumption were recorded via questionnaires, and height, weight and blood pressure were measured. Age and gender-specific incidence of AF and associations between body mass index (BMI), systolic blood pressure (SBP) and smoking were measured in 2,320,190 participants with no reported prior history of AF, stroke or CHD.
Results: The median age was 65, and two-thirds were female. The overall incidence of AF was 0.36%, but it was over twice as common in males (0.59%) than in females (0.23%) and rose sharply with age, doubling in each decade in both men and women. A positive association was seen between adiposity and AF in men and women across all ages studied: approximately 50% increase per 5 unit rise in BMI. By contrast, AF was only weakly associated with SBP - 10% increase per 10mmHg rise in SBP among participants aged under 70 years, and flat or even inversely associated among those over 70 years. Smoking was not associated with AF in men or women at any age (Odds Ratio for current vs never smokers = 0.97 [95% CI 0.79-1.19]).
Conclusion: A 10 unit increase in BMI (ie, going from an “ideal” weight to “obese”) doubled the risk of AF. However, blood pressure was less strongly associated with AF, and only in those under 70 years, suggesting some other mechanism behind the BMI - AF association. Current smoking was not associated with AF. Rising rates of obesity may be driving the observed increase in AF in the developed world.
Author Disclosures: R. Bulbulia: None. P. Sherliker: None. R. Clack: None. A. Halliday: None. R. Peto: None. S. Lewington: None.
- © 2015 by American Heart Association, Inc.