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

Carlos J. Rodriguez, Elsayed Z. Soliman, Alvaro Alonso, Katrina Swett, Peter M. Okin, David C. Goff, Susan R. Heckbert

Research output: Contribution to journalArticle

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Abstract

Purpose: 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. Methods: 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. Results: 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 7.3years. 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 65years 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%). Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)71-76.e1
JournalAnnals of Epidemiology
Volume25
Issue number2
DOIs
StatePublished - Feb 1 2015
Externally publishedYes

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Race Relations
Atrial Fibrillation
Atherosclerosis
Incidence
Population
Hispanic Americans
Hypertension
International Classification of Diseases
Ethnic Groups

Keywords

  • Atrial fibrillation
  • Chinese
  • Epidemiology
  • Hispanics

ASJC Scopus subject areas

  • Epidemiology

Cite this

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. / Rodriguez, Carlos J.; Soliman, Elsayed Z.; Alonso, Alvaro; Swett, Katrina; Okin, Peter M.; Goff, David C.; Heckbert, Susan R.

In: Annals of Epidemiology, Vol. 25, No. 2, 01.02.2015, p. 71-76.e1.

Research output: Contribution to journalArticle

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abstract = "Purpose: 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. Methods: 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. Results: 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 7.3years. 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 65years 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{\%}). Conclusions: 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.",
keywords = "Atrial fibrillation, Chinese, Epidemiology, Hispanics",
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T1 - Atrial fibrillation incidence and risk factors in relation to race-ethnicity and the population attributable fraction of atrial fibrillation risk factors

T2 - The Multi-Ethnic Study of Atherosclerosis

AU - Rodriguez, Carlos J.

AU - Soliman, Elsayed Z.

AU - Alonso, Alvaro

AU - Swett, Katrina

AU - Okin, Peter M.

AU - Goff, David C.

AU - Heckbert, Susan R.

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Purpose: 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. Methods: 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. Results: 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 7.3years. 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 65years 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%). Conclusions: 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.

AB - Purpose: 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. Methods: 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. Results: 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 7.3years. 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 65years 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%). Conclusions: 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.

KW - Atrial fibrillation

KW - Chinese

KW - Epidemiology

KW - Hispanics

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