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Association between cardiovascular risk factors and atrial fibrillation

Guohao Wu1, Jingguo Wu2, Qin Lu3

  • 1Department of General Practice, Huadu District People's Hospital, Southern Medical University, Guangzhou, China.

Frontiers in Cardiovascular Medicine
|September 27, 2023
PubMed

Insights

Cardiovascular risk factors like obesity, smoking, diabetes, and hypertension significantly increase atrial fibrillation (AF) risk. However, dyslipidemia does not appear to elevate AF risk in the general population.

Area of Science:

  • Cardiology
  • Epidemiology
  • Public Health

Background:

  • Atrial fibrillation (AF) is the most common sustained arrhythmia and a significant risk factor for cardiovascular disease.
  • The precise relationship between various cardiovascular risk factors and the incidence of AF requires further elucidation.
  • This study aims to comprehensively analyze the association between multiple cardiovascular risk factors and AF.

Purpose of the Study:

  • To quantify the risk of developing atrial fibrillation (AF) associated with specific cardiovascular risk factors.
  • To provide an updated and pooled analysis of the relationship between cardiovascular risk factors and AF incidence.
  • To inform potential screening strategies for AF based on identified risk factors.

Main Methods:

  • A systematic literature search was conducted across MEDLINE, Web of Science, and EMBASE databases up to January 15, 2022.
  • Included were prospective cohort studies reporting relative risks (RR) and 95% confidence intervals (CI) for the association between cardiovascular risk factors and AF incidence.
  • Random-effects models were used for meta-analyses of each risk factor, with PROSPERO registry number CRD42022310882.

Main Results:

  • The analysis included 101 studies with over 17 million individuals and 738,843 incident AF cases.
  • Significant increased risks for AF were observed with obesity (RR 1.39), increased BMI (RR 1.27 per 5 kg/m²), former smoking (RR 1.19), current smoking (RR 1.23), diabetes mellitus (RR 1.31), and hypertension (RR 1.68).
  • Dyslipidemia showed no statistically significant increase in AF risk (RR 1.12, 95% CI 0.95-1.32).

Conclusions:

  • Adverse cardiovascular risk factors, excluding dyslipidemia, are significantly correlated with an increased risk of developing atrial fibrillation.
  • The findings suggest that hypertension, obesity, diabetes, and smoking are key modifiable risk factors for AF.
  • The lack of association between dyslipidemia and AF may offer new insights for refining AF screening protocols.
Abstract

Keywords:
associationatrial fibrillationcardiovascular risk factorsmeta-analysis and systematic reviewprospective cohort studies

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