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Published on: February 26, 2013
Scarcity of atrial fibrillation in a traditional African population: a community-based study
Jacob J E Koopman1, David van Bodegom, Rudi G J Westendorp
1Department of Gerontology and Geriatrics, Postal zone C7-Q, Leiden University Medical Center, PO Box 9600, 2300 RC Leiden, the Netherlands. j.j.e.koopman@lumc.nl.
Insights
Atrial fibrillation is rare in a traditional African community, with only 0.3% prevalence. This low rate is linked to fewer established lifestyle-related risk factors like obesity and hypertension compared to Western populations.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Atrial fibrillation (AF) is common in Western elderly populations, associated with obesity, diabetes, hypertension, and cardiovascular disease.
- AF research has primarily focused on Western populations, potentially overlooking other demographic risk profiles.
- This study investigates AF epidemiology in a traditional African community.
Purpose of the Study:
- To determine the prevalence of atrial fibrillation in a rural African community.
- To assess established AF risk factors within this population.
- To compare findings with Western epidemiological data.
Main Methods:
- Electrocardiograms were used to detect atrial fibrillation in 924 individuals aged 50+ in rural Ghana.
- Risk factors including waist circumference, BMI, glucose, blood pressure, and myocardial infarction were recorded.
- Inflammatory markers (IL-6, CRP) were measured and compared with US reference data.
Main Results:
- Atrial fibrillation prevalence was very low at 0.3% (95% CI 0.1-1.0%).
- Low levels of obesity indicators (waist circumference, BMI) and hypertension were observed.
- C-reactive protein levels were lower compared to US reference data.
Conclusions:
- Atrial fibrillation is significantly less common in this traditional African community.
- The low prevalence is attributed to the scarcity of established Western risk factors related to lifestyle.
- Potential unmeasured genetic or environmental factors may also contribute to the observed differences.
Background:
In western societies, atrial fibrillation is an increasingly common finding among the elderly. Established risk factors of atrial fibrillation include obesity, diabetes, hypertension, and cardiovascular disease. Atrial fibrillation has almost exclusively been studied in western populations where these risk factors are widely present. Therefore, we studied the epidemiology of atrial fibrillation in a traditional African community.
Methods:
In rural Ghana, among 924 individuals aged 50 years and older, we recorded electrocardiograms to detect atrial fibrillation. As established risk factors, we documented waist circumference, body mass index (BMI), capillary glucose level, blood pressure, and electrocardiographic myocardial infarction. In addition, we determined circulating levels of interleukin-6 (IL6), a proinflammatory cytokine, and C-reactive protein (CRP), a marker of systemic inflammation. We compared the risk factors with reference data from the USA.
Results:
Atrial fibrillation was detected in only three cases, equalling 0.3% (95% CI 0.1-1.0%). Waist circumference, BMI, and capillary glucose levels were very low. Hypertension and myocardial infarction were uncommon. Circulating levels of IL6 were similar, but those of CRP were lower compared with the USA.
Conclusion:
Atrial fibrillation is very scarce in this traditional African community. Its low prevalence compared with western societies can be explained by the rareness of its established risk factors, which are closely related to lifestyle, and by possible unmeasured differences in other risk factors or genetic factors.
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