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Temporal trends of atrial fibrillation and atrial flutter burden across the BRICS: An observational study analysis

Hongbo Gao1, Chunting Liu2, Kaiqiang Tang3

  • 1First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, China.

Medicine
|February 27, 2026
PubMed

Insights

Atrial fibrillation (AF) and atrial flutter (AFL) incidence is rising in BRICS nations, driven by population growth. Demographic changes are key to managing AF/AFL burden and guiding cardiovascular care resource allocation.

Area of Science:

  • Cardiology
  • Public Health
  • Epidemiology

Background:

  • Atrial fibrillation (AF) and atrial flutter (AFL) are significant and increasing causes of cardiovascular disease globally.
  • Limited comparable long-term epidemiological data exists for AF/AFL trends across Brazil, Russia, India, China, and South Africa (BRICS).

Purpose of the Study:

  • To analyze long-term trends in AF/AFL incidence across BRICS countries.
  • To identify demographic drivers of AF/AFL burden.
  • To project future AF/AFL incidence rates and inform resource allocation for cardiovascular care.

Main Methods:

  • Population-level, retrospective ecological time-trend analysis using Global Burden of Disease 2021 estimates (1992-2021).
  • Analysis of incident cases and age-standardized incidence rates (ASIRs).
  • Application of age-period-cohort models and autoregressive integrated moving average for projections.

Main Results:

  • Incident AF/AFL cases increased across all BRICS nations, with highest 2021 counts in China and India.
  • ASIR trends varied: Brazil showed a decline followed by an uptick, China remained stable, Russia peaked then declined, India rose slightly, and South Africa declined modestly.
  • Population growth was a major driver of case increases, particularly in India, China, and South Africa.

Conclusions:

  • Demographic forces are primary determinants of the AF/AFL burden in BRICS.
  • Tailored screening, prevention, and surveillance strategies are essential.
  • Evidence-based resource allocation for cardiovascular care is needed across BRICS to address the rising AF/AFL burden.

Keywords:
BRICSGlobal Disease Burdenage-period-cohort modelatrial fibrillationatrial flutter

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