Lifetime risk of atrial fibrillation according to optimal, borderline, or elevated levels of risk factors: cohort study based on longitudinal data from the Framingham Heart Study

AbstractObjectiveTo examine the association between risk factor burdens—categorized as optimal, borderline, or elevated—and the lifetime risk of atrial fibrillation.DesignCommunity based cohort study.SettingLongitudinal data from the Framingham Heart Study.ParticipantsIndividuals free of atrial fibr...

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Vydáno v:BMJ (Online) Ročník 361; s. k1453
Hlavní autoři: Staerk, Laila, Wang, Biqi, Preis, Sarah R, Larson, Martin G, Lubitz, Steven A, Ellinor, Patrick T, McManus, David D, Ko, Darae, Weng, Lu-Chen, Lunetta, Kathryn L, Frost, Lars, Benjamin, Emelia J, Trinquart, Ludovic
Médium: Journal Article
Jazyk:angličtina
Vydáno: England British Medical Journal Publishing Group 26.04.2018
BMJ Publishing Group LTD
BMJ Publishing Group Ltd
Témata:
Age
Age Factors
Aged
Alcohol
Angina pectoris
Atrial Fibrillation - epidemiology
Atrial Fibrillation - etiology
Blood pressure
Body mass index
Cardiac arrhythmia
Cardiovascular disease
Clinical medicine
Cohort analysis
Consortia
Diabetes
Diabetes Complications - epidemiology
Diabetes mellitus
Epidemiology
Family medical history
Female
Fibrillation
Health risk assessment
Health Surveys
Heart attacks
Heart diseases
Heart failure
Humans
Hypertension
Hypertension - complications
Hypertension - epidemiology
Life Style
Longitudinal Studies
Male
Middle Aged
Mortality
Myocardial infarction
Risk Factors
Smoking
Systematic review
United States > US
ISSN:0959-8138, 1756-1833, 1756-1833
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Shrnutí:AbstractObjectiveTo examine the association between risk factor burdens—categorized as optimal, borderline, or elevated—and the lifetime risk of atrial fibrillation.DesignCommunity based cohort study.SettingLongitudinal data from the Framingham Heart Study.ParticipantsIndividuals free of atrial fibrillation at index ages 55, 65, and 75 years were assessed. Smoking, alcohol consumption, body mass index, blood pressure, diabetes, and history of heart failure or myocardial infarction were assessed as being optimal (that is, all risk factors were optimal), borderline (presence of borderline risk factors and absence of any elevated risk factor), or elevated (presence of at least one elevated risk factor) at index age.Main outcome measureLifetime risk of atrial fibrillation at index age up to 95 years, accounting for the competing risk of death.ResultsAt index age 55 years, the study sample comprised 5338 participants (2531 (47.4%) men). In this group, 247 (4.6%) had an optimal risk profile, 1415 (26.5%) had a borderline risk profile, and 3676 (68.9%) an elevated risk profile. The prevalence of elevated risk factors increased gradually when the index ages rose. For index age of 55 years, the lifetime risk of atrial fibrillation was 37.0% (95% confidence interval 34.3% to 39.6%). The lifetime risk of atrial fibrillation was 23.4% (12.8% to 34.5%) with an optimal risk profile, 33.4% (27.9% to 38.9%) with a borderline risk profile, and 38.4% (35.5% to 41.4%) with an elevated risk profile. Overall, participants with at least one elevated risk factor were associated with at least 37.8% lifetime risk of atrial fibrillation. The gradient in lifetime risk across risk factor burden was similar at index ages 65 and 75 years.ConclusionsRegardless of index ages at 55, 65, or 75 years, an optimal risk factor profile was associated with a lifetime risk of atrial fibrillation of about one in five; this risk rose to more than one in three in individuals with at least one elevated risk factor.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0959-8138
1756-1833
1756-1833
DOI:10.1136/bmj.k1453