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Atrial fibrillation in an African-American cohort: The Jackson Heart Study

Thomas R Austin1, Kerri L Wiggins2, Chad Blackshear3

  • 1Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington.

Clinical Cardiology
|July 4, 2018
PubMed

Insights

African Americans (AAs) with higher body weight, blood pressure, and smoking habits face increased risk of atrial fibrillation (AF). Interventions targeting these factors may help prevent AF in this population.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Atrial fibrillation (AF) presents a significant public health challenge across diverse racial and ethnic groups.
  • Previous studies indicated higher AF risk factor prevalence but lower incidence in African Americans (AAs) compared to whites.
  • The Jackson Heart Study (JHS) is a key community-based cohort study focusing on 5306 AAs recruited from 2000 onwards.

Purpose of the Study:

  • To investigate the association between demographic, anthropometric, cardiovascular, and electrocardiographic factors and the incidence of AF within the JHS cohort.
  • To compare AF incidence rates in JHS participants with those in African American participants from the Multi-Ethnic Study of Atherosclerosis (MESA) and the Cardiovascular Health Study (CHS).

Main Methods:

  • Utilized baseline participant characteristics and incident AF data from hospital surveillance, electrocardiograms, and Medicare claims.
  • Calculated age- and sex-specific AF incidence rates.
  • Examined the associations between cardiovascular risk factors and AF incidence, adjusting for age and sex, and subsequently for multivariable factors.

Main Results:

  • Over an average follow-up of 8.5 years, 242 incident AF cases were identified among 5306 participants.
  • AF incidence rates in JHS were comparable to AAs in MESA and slightly lower than in CHS.
  • Modifiable risk factors like high body weight (HR=1.23), elevated systolic blood pressure (HR=1.29), and current smoking (HR=1.80) were significantly associated with incident AF, with minimal attenuation after multivariable adjustments.

Conclusions:

  • Findings highlight the significant impact of modifiable risk factors on AF incidence in African Americans.
  • Emphasizes the potential public health benefits of interventions focused on weight management, hypertension control, and smoking cessation for AF prevention in AAs.
Abstract

Keywords:
Jackson Heart Studyarrhythmiaatrial fibrillation

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