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Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications
W M Feinberg1, J L Blackshear, A Laupacis
1Department of Neurology, University of Arizona Health Sciences Center, Tucson.
Insights
Atrial fibrillation (AF) affects 2.2 million Americans, primarily those over 65. Older AF patients, especially women over 75, require careful consideration for stroke prevention therapies due to bleeding risks.
Area of Science:
- Cardiology
- Epidemiology
- Geriatrics
Background:
- Atrial fibrillation (AF) prevalence increases with age.
- Anticoagulation is crucial for stroke prevention in AF but carries bleeding risks, particularly in older adults.
- Understanding the demographics of AF is vital for optimizing treatment strategies.
Purpose of the Study:
- To determine the age and sex distribution of individuals with atrial fibrillation in the US.
- To estimate the number of men and women with AF across different age groups.
- To compare the demographics of AF patients in the general population with those in clinical trials.
Main Methods:
- Review of epidemiologic data from four large population-based surveys.
- Estimation of age- and gender-specific AF prevalence.
- Application of prevalence estimates to US census data to calculate population numbers.
Main Results:
- An estimated 2.2 million Americans have AF, with a median age of 75.
- AF prevalence is 2.3% in those >40 and 5.9% in those >65.
- About 70% of AF patients are aged 65-85; women constitute 60% of AF patients over 75.
- AF patients in recent trials were younger (mean age 69) and had fewer elderly individuals compared to the general population.
Conclusions:
- The majority of individuals with AF are elderly, with a higher proportion of women in the oldest age groups.
- Older AF patients present different demographic profiles than those typically included in anticoagulation trials.
- Balancing the risks and benefits of antithrombotic therapy is critical for stroke prevention in the aging AF population.
Abstract:
The prevalence of atrial fibrillation (AF) is related to age. Anticoagulation is highly effective in preventing stroke in patients with AF, but the risk of hemorrhage may be increased in older patients. We reviewed the available epidemiologic data to define the age and sex distribution of people with AF. From four large recent population-based surveys, we estimated the overall age- and gender-specific prevalence of AF. These estimates were applied to the recent US census data to calculate the number of men and women with AF in each age group. There are an estimated 2.2 million people in the United States with AF, with a median age of about 75 years. The prevalence of AF is 2.3% in people older than 40 years and 5.9% in those older than 65 years. Approximately 70% of individuals with AF are between 65 and 85 years of age. The absolute number of men and women with AF is about equal. After age 75 years, about 60% of the people with AF are women. In contrast to people with AF in the general population, patients with AF in recent anticoagulation trials had a mean age of 69 years, and only 20% were older than 75 years. The risks and benefits of antithrombotic therapy in older individuals are important considerations in stroke prevention in AF.