A cohort study examination of established and emerging risk factors for atrial fibrillation: the Busselton Health Study

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Abstract

Atrial fibrillation (AF) is the most common chronic arrhythmia in adults and its prevalence is increasing. Due to its serious cardiovascular complications there is a strong need to understand predisposing risk factors to develop effective prevention strategies. There are a few established risk factors but a number of further risk factors have been suggested including obesity, metabolic syndrome, sleep-disordered breathing, and inflammation. The aim of this study was to investigate established and emerging risk factors for AF in a cohort study of 4,267 adults in Busselton, Western Australia, without a history of AF at baseline in 1994/95 who were followed for 15 years for incident AF events. Baseline measurement included questionnaire, clinical assessment and blood sample. A total of 343 (8 %) experienced AF during follow-up. Cox regression analysis confirmed advancing age, male sex, taller height, being on hypertension treatment and higher body mass index (BMI) as the major common risk factors (all p <0.001). However, further modelling showed the effect of being on hypertension treatment may be stronger in women (p = 0.001) and the effect of BMI stronger in men (p = 0.004). After adjustment for these factors, no other factors were strongly related (p <0.001) although short PR interval, history of valvular heart disease, stroke, chronic obstructive pulmonary disease, lung function and adiponectin level were marginally related (p <0.05). This cohort study of predictors for incident AF has confirmed the major established risk factors. However, recently suggested potential novel risk factors for AF (inflammation, sleep-disordered breathing, glucose/metabolic disorders) were not confirmed in this study.

Original languageEnglish
Pages (from-to)181-190
Number of pages10
JournalEuropean Journal of Epidemiology
Volume29
Issue number3
Early online date4 Jan 2014
DOIs
Publication statusPublished - 2014

Cite this

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title = "A cohort study examination of established and emerging risk factors for atrial fibrillation: the Busselton Health Study",
abstract = "Atrial fibrillation (AF) is the most common chronic arrhythmia in adults and its prevalence is increasing. Due to its serious cardiovascular complications there is a strong need to understand predisposing risk factors to develop effective prevention strategies. There are a few established risk factors but a number of further risk factors have been suggested including obesity, metabolic syndrome, sleep-disordered breathing, and inflammation. The aim of this study was to investigate established and emerging risk factors for AF in a cohort study of 4,267 adults in Busselton, Western Australia, without a history of AF at baseline in 1994/95 who were followed for 15 years for incident AF events. Baseline measurement included questionnaire, clinical assessment and blood sample. A total of 343 (8 {\%}) experienced AF during follow-up. Cox regression analysis confirmed advancing age, male sex, taller height, being on hypertension treatment and higher body mass index (BMI) as the major common risk factors (all p <0.001). However, further modelling showed the effect of being on hypertension treatment may be stronger in women (p = 0.001) and the effect of BMI stronger in men (p = 0.004). After adjustment for these factors, no other factors were strongly related (p <0.001) although short PR interval, history of valvular heart disease, stroke, chronic obstructive pulmonary disease, lung function and adiponectin level were marginally related (p <0.05). This cohort study of predictors for incident AF has confirmed the major established risk factors. However, recently suggested potential novel risk factors for AF (inflammation, sleep-disordered breathing, glucose/metabolic disorders) were not confirmed in this study.",
keywords = "Atrial fibrillation, Cohort study, Busselton, Health Study, Risk factor, Cox regression, METABOLIC SYNDROME, ATHEROSCLEROSIS RISK, INSULIN-RESISTANCE, PHYSICAL-ACTIVITY, SLEEP-APNEA, HEART, POPULATION, OBESITY, COMMUNITY, LUNG",
author = "Matthew Knuiman and Tom Briffa and Mark Divitini and D. Chew and J.W. Eikelboom and Brendan Mcquillan and Joe Hung",
year = "2014",
doi = "10.1007/s10654-013-9875-y",
language = "English",
volume = "29",
pages = "181--190",
journal = "European Journal of Epidemiology",
issn = "0393-2990",
publisher = "Springer",
number = "3",

}

TY - JOUR

T1 - A cohort study examination of established and emerging risk factors for atrial fibrillation

T2 - the Busselton Health Study

AU - Knuiman, Matthew

AU - Briffa, Tom

AU - Divitini, Mark

AU - Chew, D.

AU - Eikelboom, J.W.

AU - Mcquillan, Brendan

AU - Hung, Joe

PY - 2014

Y1 - 2014

N2 - Atrial fibrillation (AF) is the most common chronic arrhythmia in adults and its prevalence is increasing. Due to its serious cardiovascular complications there is a strong need to understand predisposing risk factors to develop effective prevention strategies. There are a few established risk factors but a number of further risk factors have been suggested including obesity, metabolic syndrome, sleep-disordered breathing, and inflammation. The aim of this study was to investigate established and emerging risk factors for AF in a cohort study of 4,267 adults in Busselton, Western Australia, without a history of AF at baseline in 1994/95 who were followed for 15 years for incident AF events. Baseline measurement included questionnaire, clinical assessment and blood sample. A total of 343 (8 %) experienced AF during follow-up. Cox regression analysis confirmed advancing age, male sex, taller height, being on hypertension treatment and higher body mass index (BMI) as the major common risk factors (all p <0.001). However, further modelling showed the effect of being on hypertension treatment may be stronger in women (p = 0.001) and the effect of BMI stronger in men (p = 0.004). After adjustment for these factors, no other factors were strongly related (p <0.001) although short PR interval, history of valvular heart disease, stroke, chronic obstructive pulmonary disease, lung function and adiponectin level were marginally related (p <0.05). This cohort study of predictors for incident AF has confirmed the major established risk factors. However, recently suggested potential novel risk factors for AF (inflammation, sleep-disordered breathing, glucose/metabolic disorders) were not confirmed in this study.

AB - Atrial fibrillation (AF) is the most common chronic arrhythmia in adults and its prevalence is increasing. Due to its serious cardiovascular complications there is a strong need to understand predisposing risk factors to develop effective prevention strategies. There are a few established risk factors but a number of further risk factors have been suggested including obesity, metabolic syndrome, sleep-disordered breathing, and inflammation. The aim of this study was to investigate established and emerging risk factors for AF in a cohort study of 4,267 adults in Busselton, Western Australia, without a history of AF at baseline in 1994/95 who were followed for 15 years for incident AF events. Baseline measurement included questionnaire, clinical assessment and blood sample. A total of 343 (8 %) experienced AF during follow-up. Cox regression analysis confirmed advancing age, male sex, taller height, being on hypertension treatment and higher body mass index (BMI) as the major common risk factors (all p <0.001). However, further modelling showed the effect of being on hypertension treatment may be stronger in women (p = 0.001) and the effect of BMI stronger in men (p = 0.004). After adjustment for these factors, no other factors were strongly related (p <0.001) although short PR interval, history of valvular heart disease, stroke, chronic obstructive pulmonary disease, lung function and adiponectin level were marginally related (p <0.05). This cohort study of predictors for incident AF has confirmed the major established risk factors. However, recently suggested potential novel risk factors for AF (inflammation, sleep-disordered breathing, glucose/metabolic disorders) were not confirmed in this study.

KW - Atrial fibrillation

KW - Cohort study

KW - Busselton

KW - Health Study

KW - Risk factor

KW - Cox regression

KW - METABOLIC SYNDROME

KW - ATHEROSCLEROSIS RISK

KW - INSULIN-RESISTANCE

KW - PHYSICAL-ACTIVITY

KW - SLEEP-APNEA

KW - HEART

KW - POPULATION

KW - OBESITY

KW - COMMUNITY

KW - LUNG

U2 - 10.1007/s10654-013-9875-y

DO - 10.1007/s10654-013-9875-y

M3 - Article

VL - 29

SP - 181

EP - 190

JO - European Journal of Epidemiology

JF - European Journal of Epidemiology

SN - 0393-2990

IS - 3

ER -