The Determinants of the 13-Year Risk of Incident Atrial Fibrillation in a Russian Population Cohort of Middle and Elderly Age

Abstract

Atrial fibrillation (AF) is the most common arrhythmia and a predictor of the complications of atherosclerotic cardiovascular diseases (ASCVDs), particularly thromboembolic events and the progression of heart failure. We analyzed the determinants of the 13-year risk of incident AF in a Russian population cohort of middle and elderly age. A random population sample (n = 9360, age 45–69 years) was examined at baseline in 2003–2005 and reexamined in 2006–2008 and 2015–2017 in Novosibirsk (the HAPIEE study). Incident AF was being registered during the average follow-up of 13 years. The final analysis included 3871 participants free from baseline AF and cardiovascular disease (CVD) who participated in all three data collections. In a multivariable-adjusted Cox regression model, the 13-year risk of AF was positively associated with the male sex (hazard ratio (HR) = 2.20; 95% confidence interval (CI) 1.26–3.87); age (HR = 1.10 per year; 95% CI 1.07–1.14); body mass index (BMI), (HR = 1.11 per unit; 95% CI 1.07–1.15); systolic blood pressure (SBP), (HR = 1.02 per 1 mmHg; 95% CI 1.01–1.02), and it was negatively associated with total cholesterol (TC), (HR = 0.79 per 1 mmol/L; 95% CI 0.66–0.94). In women, the risk of AF was more strongly associated with hypertension (HT) and was also negatively related to total cholesterol (TC) level (HR = 0.74 per 1 mmol/L; 95% CI 0.56–0.96). No independent association was found with mean alcohol intake per drinking occasion. These results in a Russian cohort have an implication for the prediction of AF and ASCVD complications in the general population.

Blood pressure, hypertension and the risk of atrial fibrillation: a systematic review and meta-analysis of cohort studies

“…Two publications [ 42 , 75 ] reported results from two separate studies each and one publication reported results from five separate studies [ 29 ], two of which were included in the main analysis (the other three were surpassed by more recent publications, but results of two of these duplicate studies were included in subgroup analyses by ethnicity). Twenty six studies (23 publications) [ 18 , 20 , 21 , 25 , 27 – 30 , 33 , 36 , 42 , 43 , 48 , 54 , 64 , 65 , 69 , 71 – 73 , 75 , 76 , 78 ] were from Europe, twenty studies (25 publications) [ 7 , 17 , 19 , 22 , 24 , 26 , 29 , 31 , 34 , 37 , 40 , 41 , 45 – 47 , 52 , 53 , 56 , 59 , 67 , 68 , 70 , 74 , 77 , 81 ] were from North America, nineteen studies (19 publications) [ 23 , 32 , 35 , 38 , 39 , 44 , 49 – 51 , 55 , 57 , 60 – 63 , 66 , 79 , 80 , 82 ] were from Asia, and three studies (3 publications) [ 8 , 9 , 58 ...…”

“…Although elevated blood pressure is an established risk factor for several cardiovascular diseases, data regarding blood pressure and risk of atrial fibrillation have to our knowledge not been summarized in a meta-analysis. A large number of cohort studies have investigated the association between hypertension and the risk of atrial fibrillation [ 7 – 9 , 17 – 65 ], and most of these found an increased risk [ 7 , 8 , 17 – 22 , 24 – 31 , 33 , 34 , 36 – 49 , 51 – 62 , 64 , 65 ], with few studies reporting no association [ 9 , 23 , 32 , 35 , 50 , 63 ], however, the strength of the association has differed considerably between studies with reported relative risks reported ranging from 0.93 to 2.85 [ 7 – 9 , 17 – 59 ]. In addition, several studies have investigated the association between systolic [ 8 , 18 , 20 , 29 , 33 , 34 , 39 , 41 , 42 , 44 , 46 , 51 , 55 , 63 , 65 – 80 ] or diastolic [ 8 , 29 , 33 , 39 , 41 , 44 , 46 , 51 , 55 , 67 – 70 , 72 – 74 , 79 , 81 ] blood pressure and risk of atrial fibrillation with most studies reporting increased risk for increasing systolic blood pressure [ 18 , 20 ...…”

“…A large number of cohort studies have investigated the association between hypertension and the risk of atrial fibrillation [ 7 – 9 , 17 – 65 ], and most of these found an increased risk [ 7 , 8 , 17 – 22 , 24 – 31 , 33 , 34 , 36 – 49 , 51 – 62 , 64 , 65 ], with few studies reporting no association [ 9 , 23 , 32 , 35 , 50 , 63 ], however, the strength of the association has differed considerably between studies with reported relative risks reported ranging from 0.93 to 2.85 [ 7 – 9 , 17 – 59 ]. In addition, several studies have investigated the association between systolic [ 8 , 18 , 20 , 29 , 33 , 34 , 39 , 41 , 42 , 44 , 46 , 51 , 55 , 63 , 65 – 80 ] or diastolic [ 8 , 29 , 33 , 39 , 41 , 44 , 46 , 51 , 55 , 67 – 70 , 72 – 74 , 79 , 81 ] blood pressure and risk of atrial fibrillation with most studies reporting increased risk for increasing systolic blood pressure [ 18 , 20 , 29 , 34 , 39 , 41 , …”

Basic Research in Atherosclerosis: Technologies of Personalized Medicine

“…The easily calculated immunological ratios of blood cells and Lp(a) concentrations can be considered simple predictors of future cardiovascular events. Shapkina et al [6] investigated the determinants of the 13-year risk of incident atrial fibrillation (AF) in a Russian population cohort of middle and elderly age. A random population sample (n = 9360, age 45-69 years) was examined at baseline in 2003-2005 and reexamined in 2006-2008 and 2015-2017 in Novosibirsk (the HAPIEE study).…”

“…Shapkina et al [ 6 ] investigated the determinants of the 13-year risk of incident atrial fibrillation (AF) in a Russian population cohort of middle and elderly age. A random population sample ( n = 9360, age 45–69 years) was examined at baseline in 2003–2005 and reexamined in 2006–2008 and 2015–2017 in Novosibirsk (the HAPIEE study).…”