Predictors of incident atrial fibrillation and influence of medications: a retrospective case–control study

Hodgkinson, James; Taylor, Clare; Hobbs, FD Richard

doi:10.3399/bjgp11x578034

Cited by 18 publications

(14 citation statements)

References 60 publications

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“…All but one of the studies found increased risk, but the strength of the association differed between studies. In sensitivity analyses excluding the most influential studies, the summary RR ranged from 1.27 (95% CI: 1.18–1.37) when excluding the Danish Military Conscripts study [28] to 1.30 (95% CI: 1.23–1.38) when excluding the UK General Practice Research Database Study [20]. There was no indication of publication bias with Egger’s test, p = 0.31, or with Begg’s test, p = 0.44, however, by inspection of the funnel plot there was some evidence of asymmetry with potentially smaller negative studies missing (Supplementary Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Overweight and obesity have been associated with increased risk of atrial fibrillation in several studies [18, 19]. Some studies suggested a J-shaped dose–response relationship between BMI and atrial fibrillation [20, 21], however, other studies suggested a linear association [22–28]. In addition, it is not clear whether other measures of body fatness such as waist circumference [26, 29–32], hip circumference [30, 32, 33], waist-to-hip ratio [29, 30, 32, 33], fat mass [30–32, 34], or body fat percentage [30, 31, 34] are associated with risk of atrial fibrillation or if the association differs by geographic location or ethnicity.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, it is not clear whether other measures of body fatness such as waist circumference [26, 29–32], hip circumference [30, 32, 33], waist-to-hip ratio [29, 30, 32, 33], fat mass [30–32, 34], or body fat percentage [30, 31, 34] are associated with risk of atrial fibrillation or if the association differs by geographic location or ethnicity. Although a meta-analysis from 2008 found that both overweight and obesity as measured by body mass index (BMI) was associated with increased risk of atrial fibrillation [35], at least 20 additional studies involving >78,000 atrial fibrillation cases and >2.2 million participants have been published since that meta-analysis [20, 21, 23–31, 33, 34, 36–42]. Given the large number of additional studies that have been published since the previous meta-analysis and the availability of data regarding other adiposity measures as well, we conducted a systematic review and dose–response meta-analysis of prospective studies that investigated the association between body mass index, waist circumference, waist-to-hip ratio, or other measures of adiposity (hip circumference, fat mass, weight, weight gain) and the risk of atrial fibrillation.…”

Section: Introductionmentioning

confidence: 99%

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Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose–response meta-analysis of prospective studies

et al. 2017

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Different adiposity measures have been associated with increased risk of atrial fibrillation, however, results have previously only been summarized for BMI. We therefore conducted a systematic review and meta-analysis of prospective studies to clarify the association between different adiposity measures and risk of atrial fibrillation. PubMed and Embase databases were searched up to October 24th 2016. Summary relative risks (RRs) were calculated using random effects models. Twenty-nine unique prospective studies (32 publications) were included. Twenty-five studies (83,006 cases, 2,405,381 participants) were included in the analysis of BMI and atrial fibrillation. The summary RR was 1.28 (95% confidence interval: 1.20–1.38, I2 = 97%) per 5 unit increment in BMI, 1.18 (95% CI: 1.12–1.25, I2 = 73%, n = 5) and 1.32 (95% CI: 1.16–1.51, I2 = 91%, n = 3) per 10 cm increase in waist and hip circumference, respectively, 1.09 (95% CI: 1.02–1.16, I2 = 44%, n = 4) per 0.1 unit increase in waist-to-hip ratio, 1.09 (95% CI: 1.02–1.16, I2 = 94%, n = 4) per 5 kg increase in fat mass, 1.10 (95% CI: 0.92–1.33, I2 = 90%, n = 3) per 10% increase in fat percentage, 1.10 (95% CI: 1.08–1.13, I2 = 74%, n = 10) per 5 kg increase in weight, and 1.08 (95% CI: 0.97–1.19, I2 = 86%, n = 2) per 5% increase in weight gain. The association between BMI and atrial fibrillation was nonlinear, p nonlinearity < 0.0001, with a stronger association at higher BMI levels, however, increased risk was observed even at a BMI of 22–24 compared to 20. In conclusion, general and abdominal adiposity and higher body fat mass increase the risk of atrial fibrillation.Electronic supplementary materialThe online version of this article (doi:10.1007/s10654-017-0232-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose–response meta-analysis of prospective studies

et al. 2017

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“…Since the prevalence of AF increases with advancing age 2 , it is anticipated that the burden of AF will gradually increase with the aging US population. Data from prior studies have demonstrated beneficial effects of light-to-moderate physical activity on AF risk 3 , positive associations with obesity 4 , inflammation 5 , sleep apnea 6 , heavy alcohol consumption 7 , hypertension (HTN) 7 , type 2 diabetes (T2D) 8 , and dyslipidemia 9 . Recent data suggest that too little sleep or too much sleep may be each associated with adverse health outcomes including obesity 10 , inflammation 11 , HTN 12 , T2D 13 , dyslipdemia 14,15 , cardiovascular disease (CVD) 16 , and total mortality 17 .…”

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confidence: 99%

Sleep Duration and Risk of Atrial Fibrillation (from the Physicians' Health Study)

Khawaja

Sarwar

Chen

et al. 2013

The American Journal of Cardiology

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While sleep quality and duration have been related to cardiovascular endpoints, little is known about the association between sleep duration and incident atrial fibrillation (AF). Hence, we prospectively examined the association between sleep duration and incident AF in a cohort of 18,755 US male physicians. Self-reported sleep duration was ascertained during 2002 annual follow-up questionnaire. Incident AF was ascertained through yearly follow-up questionnaires. Cox regression was used to estimate relative risks of AF. The average age at baseline was 67.7 (+8.6) years. During a mean follow up of 6.9 (±2.1) years, 1,468 cases of AF occurred. Using 7 hours of sleep as the reference group, multivariable adjusted hazard ratios (95% CI) for AF were 1.06 (0.92–1.22), 1.0 (ref), and 1.13 (1.00–1.27) from the lowest to the highest category of sleep duration (p for trend 0.26), respectively. In a secondary analysis, there was no evidence of effect modification by adiposity (p interaction =0.69); however, prevalent sleep apnea modified the relation of sleep duration with AF (p interaction =0.01): from the highest to the lowest category of sleep duration, multivariable adjusted hazard ratios (95% CI) for AF were 2.26 (1.26–4.05), 1.0 (ref), and 1.34 (0.73–2.46) for those with prevalent sleep apnea and 1.01 (0.87–1.16), 1.0 (ref), and 1.12 (0.99–1.27) for those without sleep apnea, respectively. Our data showed a modestly elevated risk of AF with long sleep duration among US male physicians. Furthermore, shorter sleep duration was associated with a higher risk of AF in people with prevalent sleep apnea.

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“…Data from prior studies have demonstrated beneficial effects of light-to-moderate physical activity on AF risk 7 . In contrast, there is a positive relation between obesity 8 , inflammation 9 , heavy alcohol consumption 10 , hypertension 10 , type 2 diabetes mellitus (T2DM) 11 , and dyslipidemia 12 with AF. There is evidence for a beneficial effect of certain foods such as olive oil, nuts, fish, fruits, vegetables, fiber, whole grains on cardiovascular health 13,14 .…”

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confidence: 98%

Chocolate Consumption and Risk of Atrial Fibrillation (from the Physicians' Health Study)

Khawaja

Petrone

Kanjwal

et al. 2015

The American Journal of Cardiology

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Chocolate consumption has been shown to protect against various cardiovascular endpoints, however little is known about the association between chocolate consumption and incident atrial fibrillation (AF). Therefore, we prospectively examined the association between chocolate consumption and incident AF in a cohort of 18,819 US male physicians. Chocolate consumption was ascertained between 1999 and 2002 via a self-administered food frequency questionnaire. Incident AF was ascertained through yearly follow-up questionnaires. Cox regression was used to estimate relative risks of AF. The average age at baseline was 66 (±9.1) years. During a mean follow up of 9.0 (±3.0) years, 2,092 cases of AF occurred. Using <1/month of chocolate consumption as the reference group, multivariable adjusted hazard ratios (95% confidence interval) for AF were 1.04 (0.93-1.18), 1.10 (0.96-1.25), 1.14 (0.99-1.31), and 1.05 (0.89-1.25) for chocolate intake of 1-3/month, 1/week, 2-4/week, and ≥5/week (p for trend 0.25), respectively. In a secondary analysis, there was no evidence of effect modification by adiposity (p interaction = 0.71) or age (p interaction = 0.26). In conclusion, our data did not support an association between chocolate consumption and risk of AF among US male physicians.

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Predictors of incident atrial fibrillation and influence of medications: a retrospective case–control study

Cited by 18 publications

References 60 publications

Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose–response meta-analysis of prospective studies

Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose–response meta-analysis of prospective studies

Sleep Duration and Risk of Atrial Fibrillation (from the Physicians' Health Study)

Chocolate Consumption and Risk of Atrial Fibrillation (from the Physicians' Health Study)

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