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. 2021 Oct 28;7(6):574-582.
doi: 10.1093/ehjqcco/qcaa061.

Global, regional, and national prevalence, incidence, mortality, and risk factors for atrial fibrillation, 1990-2017: results from the Global Burden of Disease Study 2017

Haijiang Dai  1   2 , Quanyu Zhang  3 , Arsalan Abu Much  4   5 , Elad Maor  4   5 , Amit Segev  4   5 , Roy Beinart  4   5 , Salim Adawi  6   7 , Yao Lu  2   8 , Nicola Luigi Bragazzi  1 , Jianhong Wu  1
Affiliations

Global, regional, and national prevalence, incidence, mortality, and risk factors for atrial fibrillation, 1990-2017: results from the Global Burden of Disease Study 2017

Haijiang Dai et al. Eur Heart J Qual Care Clin Outcomes. .

Abstract

Aims: To estimate the prevalence, incidence, mortality, and risk factors for atrial fibrillation (AF) in 195 countries and territories from 1990 to 2017.

Methods and results: Following the methodologies used in the Global Burden of Disease Study 2017, the prevalence, incidence, and mortality of AF were analysed by age, sex, year, socio-demographic index (SDI), and location. The percentage contributions of major risk factors to age-standardized AF deaths were measured by population attributable fractions. In 2017, there were 37.57 million [95% uncertainty interval (UI) 32.55-42.59] prevalent cases and 3.05 million (95% UI 2.61-3.51) incident cases of AF globally, contributing to 287 241 (95% UI 276 355-304 759) deaths. The age-standardized rates of prevalent cases, incident cases, and deaths of AF in 2017 and their temporal trends from 1990 to 2017 varied significantly by SDI quintile and location. High systolic blood pressure was the leading risk factor for AF age-standardized deaths [34.3% (95% UI 27.4-41.5)] in 2017, followed by high body mass index [20.7% (95% UI 11.5-32.2)] and alcohol use [9.4% (95% UI 7.0-12.2)].

Conclusion: Our study has systematically and globally assessed the temporal trends of AF, which remains a major public heath challenge. Although AF mainly occurred in developed countries, the unfavourable trend in countries with lower SDI also deserves particular attention. More effective prevention and treatment strategies aimed at counteracting the increase in AF burden should be established in some countries.

Keywords: Atrial fibrillation; Incidence; Mortality; Prevalence; Risk factor.

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Figures

Figure 1
Figure 1
Age-specific counts and rates of prevalent cases (A), incident cases (B), and deaths (C) of atrial fibrillation by sex, 2017. Error bars and shading represent 95% uncertainty intervals.
Figure 2
Figure 2
Age-standardized incidence (A) and mortality (B) rates of atrial fibrillation across 195 countries and territories for both sexes combined, 2017. ATG, Antigua and Barbuda; FSM, Federated States of Micronesia; Isl, Islands; LCA, Saint Lucia; TLS, Timor-Leste; TTO, Trinidad and Tobago; VCT, Saint Vincent and the Grenadines.
Figure 3
Figure 3
Temporal trends in counts and age-standardized rates of atrial fibrillation incident cases and deaths by socio-demographic index quintile for both sexes combined, 1990–2017. (A) Trends in counts of atrial fibrillation incident cases by socio-demographic index quintile, 1990–2017. (B) Trends in counts of atrial fibrillation deaths by socio-demographic index quintile, 1990–2017. (C) Trends in age-standardized incidence rates of atrial fibrillation by socio-demographic index quintile, 1990–2017. (D) Trends in age-standardized mortality rates of atrial fibrillation by socio-demographic index quintile, 1990–2017. AF, atrial fibrillation; SDI, socio-demographic index.
Figure 4
Figure 4
Percentage contributions of major risk factors to atrial fibrillation age-standardized deaths by sex and socio-demographic index quintile, 2017. Error bars and shading represent 95% uncertainty intervals. SDI, socio-demographic index.
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