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Association between Obesity and Heart Failure and Related Atrial Fibrillation: Patient-Level Data Comparisons of Two
Young Shin Lee1, Pil-Sung Yang2, Eunsun Jang1
1Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.
Insights
Obesity increases heart failure (HF) and atrial fibrillation (AF) risk in both Korean and UK adults. The UK, with higher obesity rates, showed a greater incidence of HF and HF-related AF compared to Korea.
Area of Science:
- Cardiology
- Epidemiology
- Public Health
Background:
- Heart failure (HF) and atrial fibrillation (AF) frequently coexist, impacting a significant portion of patients with either condition.
- Understanding the influence of obesity on the relationship between HF and AF is crucial for targeted interventions.
Purpose of the Study:
- To evaluate differences in the obesity-mediated association between heart failure and heart failure-related atrial fibrillation among Asian (Korean) and European (UK) populations.
- To compare the incidence and risk of HF and HF-related AF based on body mass index (BMI) across these distinct ethnic groups.
Main Methods:
- Utilized large-scale cohort data from the Korean National Health Insurance Service-Health Screening (K-NHIS-HealS) and the UK Biobank.
- Included 394,801 Korean adults and 476,883 UK adults, aged 40-70 years.
- Assessed the incidence and risk of HF and HF-related AF in relation to body mass index (BMI).
Main Results:
- The UK cohort exhibited a significantly higher proportion of obese individuals (24.2%) compared to the Korean cohort (2.7%).
- Obese individuals in the UK showed higher incidence rates of HF and HF-related AF than their Korean counterparts.
- Obesity was associated with a 1.82-fold risk of HF in Koreans and a 2.00-fold risk in UK adults, with a significant interaction effect (p<0.001).
- A 5-unit increase in BMI correlated with a 44% higher risk of HF-related AF in the UK, but not significantly in Korea.
Conclusions:
- Obesity is a significant risk factor for both heart failure and heart failure-related atrial fibrillation in both Korean and UK populations.
- The higher prevalence of obesity in the UK likely contributes to the observed greater incidence of HF and HF-related AF in this population.
- Findings highlight ethnic and regional differences in the impact of obesity on cardiovascular health outcomes.
Purpose:
Heart failure (HF) and atrial fibrillation (AF) frequently coexist, with over 50% patients with HF having AF, while one-third of those with AF develop HF. Differences in obesity-mediated association between HF and HF-related AF among Asians and Europeans were evaluated.
Materials And Methods:
Using the Korean National Health Insurance Service-Health Screening (K-NHIS-HealS) cohort and the UK Biobank, we included 394801 Korean and 476883 UK adults, respectively aged 40-70 years. The incidence and risk of HF were evaluated based on body mass index (BMI).
Results:
The proportion of obese individuals was significantly higher in the UK Biobank cohort than in the K-NHIS-HealS cohort (24.2% vs. 2.7%, p<0.001). The incidence of HF and HF-related AF was higher among the obese in the UK than in Korea. The risk of HF was higher among the British than in Koreans, with adjusted hazard ratios of 1.82 [95% confidence interval (CI), 1.30-2.55] in K-NHIS-HealS and 2.00 (95% CI, 1.69-2.37) in UK Biobank in obese participants (p for interaction <0.001). A 5-unit increase in BMI was associated with a 44% greater risk of HF-related AF in the UK Biobank cohort (p<0.001) but not in the K-NHIS-HealS cohort (p=0.277).
Conclusion:
Obesity was associated with an increased risk of HF and HF-related AF in both Korean and UK populations. The higher incidence in the UK population was likely due to the higher proportion of obese individuals.
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