Related Experiment Videos
Risk factor changes and incident atrial fibrillation among middle-aged men in the Malmö Preventive Project cohort
Linda S B Johnson1, Tord Juhlin2, Gunnar Engström2
1Department of Clinical Sciences, Lund University, Skåne University Hospital, Inga-Marie Nilssons väg 49, S-205 02 Malmö, Sweden linda.johnson@med.lu.se.
Aims:
To determine whether risk factor changes over 6 years were associated with the incidence of atrial fibrillation (AF) among middle-aged men in the Malmö Preventive Project (MPP) cohort.
Methods And Results:
In total, 5633 men (mean age 47.0 years at baseline) underwent two screening examinations, separated by an average of 6 years. The annual rate at which systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, fasting blood glucose (FBG), blood glucose at 2-h oral glucose tolerance test (OGTT), and screening spirometry values changed was calculated and analysed in relation to incident AF, using Cox and competing risks regression to determine hazard ratios (HRs) and 95% confidence intervals (CIs). Mean follow-up time ± SD from rescreening was 22.3 ± 7.4 years. Significant associations were found between the annual increase of SBP (HR: 1.04, 95% CI: 1.01-1.07, P = 0.003 per mmHg), DBP (HR: 1.06, 95% CI: 1.01-1.1, P = 0.024 per mmHg), FBG (HR: 2.11, 95% CI: 1.44-3.12, P < 0.0001 per mmol/L), and weight (HR: 1.14, 95% CI: 1.05-1.24, P = 0.003 per kg) on the one hand and incident AF on the other, after full adjustment for baseline age, height, weight, SBP, FBG, smoking status, sedentary lifestyle, anti-hypertensive treatment, screening year, and low socioeconomic status.
Conclusion:
The age-adjusted annual rates of increase in SBP, DBP, weight, and FBG in mid-life are associated with AF incidence in men. This raises the question of whether preventive measures directed at individuals with high annual increases, even within the normal range, would reduce AF incidence.
Insights
Increases in systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, and fasting blood glucose (FBG) over time are linked to a higher risk of developing atrial fibrillation (AF) in middle-aged men. These findings suggest potential targets for AF prevention strategies.
Area of Science:
- Cardiology
- Preventive Medicine
- Epidemiology
Background:
- Atrial fibrillation (AF) is a significant public health concern, particularly in aging populations.
- Identifying modifiable risk factors for AF is crucial for developing effective prevention strategies.
Purpose of the Study:
- To investigate the association between changes in cardiovascular risk factors over a 6-year period and the incidence of atrial fibrillation (AF) in middle-aged men.
- To determine if longitudinal changes in blood pressure, weight, and glucose metabolism predict future AF events.
Main Methods:
- Analysis of data from 5633 men in the Malmö Preventive Project (MPP) cohort, with two screening examinations an average of 6 years apart.
- Calculation of annual rates of change for systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, and fasting blood glucose (FBG).
- Use of Cox and competing risks regression to assess the relationship between risk factor changes and incident AF, adjusting for multiple baseline covariates.
Main Results:
- A significant association was found between the annual increase in SBP (HR: 1.04 per mmHg), DBP (HR: 1.06 per mmHg), weight (HR: 1.14 per kg), and FBG (HR: 2.11 per mmol/L) and the incidence of AF.
- These associations remained significant after adjusting for baseline risk factors, lifestyle, and socioeconomic status.
- The study highlights the importance of monitoring longitudinal changes in these risk factors.
Conclusions:
- Age-adjusted annual increases in SBP, DBP, weight, and FBG during mid-life are associated with an increased incidence of AF in men.
- These findings suggest that interventions targeting individuals with even modest annual increases in these risk factors, within the normal range, may help reduce AF incidence.
- Further research is warranted to explore the clinical utility of these longitudinal risk factor changes in AF prevention programs.