Global burden of atrial fibrillation/flutter due to high systolic blood pressure from 1990 to 2019: estimates from the global burden of disease study 2019

Abstract

Atrial fibrillation/atrial flutter (AF/AFL) has progressed to be a public health concern, and high systolic blood pressure (HSBP) remains the leading risk factor for AF/AFL. This study estimated the HSBP attributable AF/AFL burden based on the data from the Global Burden of Disease (GBD) study 2019. Numbers, age-standardized rates (ASR) of deaths, disability-adjusted life years (DALYs), and corresponding estimated annual percentage change (EAPC) were analyzed by age, sex, sociodemographic index (SDI), and locations. Gini coefficient was calculated to evaluate health inequality. Globally, HSBPrelated AF/AFL caused 107 091 deaths and 3 337 876 DALYs in 2019, an increase of 142.5% and 105.9% from 1990, respectively. The corresponding mortality and DALYs ASR declined by 5.8% and 7.7%. High-income Asia Pacific experienced the greatest decrease in mortality and DALYs ASR, whereas the largest increase was observed in Andean Latin America. Almost half of the HSBP-related AF/AFL burden was carried by high and high-middle SDI regions, and it was experiencing a shift to lower SDI regions.A negative correlation was detected between EAPC and SDI. Females and elderly people tended to have a higher AF/AFL burden, whereas young adults (30-49 years old) experienced an annual increase in AF/AFL burden. The Gini index of DALYs rate decreased from 0.224 in 1990 to 0.183 in 2019. Despite improved inequality having been observed over the past decades, the HSBP-related AF/AFL burden varied across regions, sexes, and ages. Cost-effective preventive, diagnostic, and therapeutic tools are required to be implemented in less developed regions. K E Y W O R D Satrial fibrillation/atrial flutter, deaths and DALYs, global disease burden 2019, high systolic blood pressure Yaqiong Jin and Keke Wang contributed equally.

Catheter ablation of atrial fibrillation in the young: a systematic review and meta-analysis

“…After catheter ablation of paroxysmal AF, recent long-term follow-up data showed an unexpectedly low progression rate to permanent AF [37] . Based on this observation, it may be preferable to do an early AF ablation in the young patient rather than waiting until AF has developed into persistent AF, which may then require a lengthy ablation treatment with a lower chance of success [38] . The better outcome was probably caused by younger patients having less electroanatomical remodeling than older patients [39] .To better explain the positive response younger patients demonstrated in comparison to the propensity-matched older group, a more extensive assessment of the electroanatomic substrate (such as high-density mapping, evaluation of cardiac fibrosis, and atrial mechanical characteristics) is required.…”

The burden of atrial fibrillation/flutter in the Middle East and North Africa region and its associated risk factors from 1990 to 2019

“…A precise assessment of the current burden and underlying risk factors specific to the Middle East and North Africa (MENA) region is crucial for devising effective strategies to combat AF/AFL and its complications. While previous studies from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 have addressed the global impact of AF/AFL [ 7 , 8 , 15 , 16 ], to our knowledge, there lacks an updated evaluation providing a comprehensive analysis of various factors encompassing prevalence, incidence rates, Disability-Adjusted Life Years (DALYs), mortality rates, and significant risk factors specific to AF/AFL in MENA over time. Thus, this study explores the burden and associated risk factors of AF/AFL in MENA between 1990 and 2019, leveraging data from GBD provided by the Institute of Health Metrics and Evaluation (IHME).…”