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Comparative Study
. 2018 Jul;11(7):e006350.
doi: 10.1161/CIRCEP.118.006350.

Lifetime Risk of Atrial Fibrillation by Race and Socioeconomic Status: ARIC Study (Atherosclerosis Risk in Communities)

Liping Mou  1 , Faye L Norby  2 , Lin Y Chen  3 , Wesley T O'Neal  4 , Tené T Lewis  5 , Laura R Loehr  6 , Elsayed Z Soliman  7 , Alvaro Alonso  8
Affiliations
Comparative Study

Lifetime Risk of Atrial Fibrillation by Race and Socioeconomic Status: ARIC Study (Atherosclerosis Risk in Communities)

Liping Mou et al. Circ Arrhythm Electrophysiol. 2018 Jul.

Abstract

Background: Limited information exists on the lifetime risk of atrial fibrillation (AF) in African Americans and by socioeconomic status.

Methods: We studied 15 343 participants without AF at baseline from the ARIC (Atherosclerosis Risk in Communities) cohort recruited in 1987 to 1989 from 4 communities in the United States when they were 45 to 64 years of age. Participants have been followed through 2014. Incidence rates of AF were calculated dividing the number of new cases by person-years of follow-up. Lifetime risk of AF was estimated by a modified Kaplan-Meier method considering death as a competing risk. Participants' family income and education were obtained at baseline.

Results: We identified 2760 AF cases during a mean follow-up of 21 years. Lifetime risk of AF was 36% (95% confidence interval, 32%-38%) in white men, 30% (95% confidence interval, 26%-32%) in white women, 21% (95% confidence interval, 13%-24%) in African American men, and 22% (95% confidence interval, 16%-25%) in African American women. Regardless of race and sex, incidence rates of AF decreased from the lowest to the highest categories of income and education. In contrast, lifetime risk of AF increased in individuals with higher income and education in most sex-race groups. Cumulative incidence of AF was lower in those with higher income and education compared with their low socioeconomic status counterparts through earlier life but was reversed after age 80.

Conclusions: Lifetime risk of AF in the ARIC cohort was ≈1 in 3 among whites and 1 in 5 among African Americans. Socioeconomic status was inversely associated with cumulative incidence of AF before the last decades of life.

Keywords: atherosclerosis; atrial fibrillation; incidence; income; stroke.

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Figures

Figure 1
Figure 1. Race- and sex-specific adjusted cumulative incidence of AF, Atherosclerosis Risk in Communities Study, 1987–2014. Lifetime risk is cumulative risk through 92 years of age
AAM: African American men; AAW: African American women; WM: white men; WW: white women
Figure 2
Figure 2. Adjusted cumulative incidence of AF from age 45 to 92 by income, education, race and sex, Atherosclerosis Risk in Communities Study, 1987–2014
A: By income categories in whites. B: By income categories in African Americans. C: By education categories in whites. D: By education categories in African Americans. AAM: African American men. AAW: African American women. WM: white men. WW: white women.
Figure 3
Figure 3. Adjusted cumulative incidence of AF from age 45 to 92 by quartiles of predicted 5-year risk of AF, Atherosclerosis Risk in Communities Study, 1987–2014
Q1: predicted risk ≤ 0.4%. Q2: 0.4% < predicted risk ≤ 0.8%. Q3: 0.8% < predicted risk ≤ 1.5%. Q4: predicted risk > 1.5%.
See this image and copyright information in PMC

Comment in

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