Atrial fibrillation incidence and risk factors in relation to race-ethnicity and the population attributable fraction of atrial fibrillation risk factors: the Multi-Ethnic Study of Atherosclerosis

We studied incident atrial fibrillation (AF) in the prospective community-based Multi-Ethnic Study of Atherosclerosis (MESA). Reportedly, non-Hispanic blacks (NHBs) have a lower AF burden compared with their non-Hispanic white (NHW) counterparts. Information on the epidemiology of AF in Hispanic and...

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Published in:Annals of epidemiology Vol. 25; no. 2; pp. 71 - 76.e1
Main Authors: Rodriguez, Carlos J., Soliman, Elsayed Z., Alonso, Alvaro, Swett, Katrina, Okin, Peter M., Goff, David C., Heckbert, Susan R.
Format: Journal Article
Language:English
Published: United States Elsevier Inc 01.02.2015
Subjects:
Age Factors
Asian
Atrial fibrillation
Atrial Fibrillation - ethnology
Black or African American
China - ethnology
Chinese
Diabetes Mellitus - ethnology
epidemiology
Ethnicity - statistics & numerical data
Female
Health Behavior - ethnology
Hispanic or Latino
Hispanics
Humans
Hypertension - ethnology
Incidence
Internal Medicine
Longitudinal Studies
Male
Obesity - ethnology
Prospective Studies
Racial Groups - statistics & numerical data
Risk Factors
Sex Factors
Smoking - ethnology
Socioeconomic Factors
United States - epidemiology
United States
China
epidemiology
Chinese
Atrial fibrillation
Hispanics
ISSN:1047-2797, 1873-2585, 1873-2585
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Summary:We studied incident atrial fibrillation (AF) in the prospective community-based Multi-Ethnic Study of Atherosclerosis (MESA). Reportedly, non-Hispanic blacks (NHBs) have a lower AF burden compared with their non-Hispanic white (NHW) counterparts. Information on the epidemiology of AF in Hispanic and Asian populations is much more limited. We excluded participants with a history of AF at enrollment. A total of 6721 MESA participants were monitored for the first AF event ascertained according to hospital discharge International Classification of Diseases, Ninth Revision, codes. Age- and sex-adjusted incidence rates (IRs) of AF were calculated per 1000 person-years of observation. IR ratios were calculated using NHWs as the reference group. Age- and sex-adjusted population attributable fractions (PAFs) of established modifiable AF risk factors were ascertained. In the MESA cohort, 47.2% was male; at baseline, 25.7% had hypertension; 12.5% had diabetes. Three hundred five incident hospitalized AF events occurred over a mean follow-up of 7.3 years. Age- and sex-adjusted IRs and IR ratios showed that overall AF incidence was significantly lower among Hispanics, NHBs and Chinese compared with NHWs (all P < .001). Among participants 65 years of age or greater, Hispanics, Chinese, and blacks had significantly lower AF incidence than NHWs (all P ≤ .01), but IRs were similar among participants under age 65 years. The PAF for smoking was 27% among NHBs but lower among other race–ethnic groups. Among NHWs, the PAF for hypertension was 22.2%, but this was higher among NHBs (33.1%), Chinese (46.3%), and Hispanics (43.9%). Overall, the incidence of hospitalized AF was significantly lower in Hispanics, NHBs, and Chinese than in NHWs. A larger proportion of AF events appear to be attributable to hypertension among nonwhite populations compared with NHWs.
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ISSN:1047-2797
1873-2585
1873-2585
DOI:10.1016/j.annepidem.2014.11.024