Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Sep 23;119(5):724-731.
doi: 10.36660/abc.20210970. Online ahead of print.

Cardiovascular Health and Atrial Fibrillation or Flutter: A Cross-Sectional Study from ELSA-Brasil

[Article in Portuguese, English]
Itamar S Santos  1   2 , Paulo A Lotufo  1   2 , Alessandra C Goulart  2 , Luisa C C Brant  3 , Marcelo M Pinto Filho  4 , Alexandre C Pereira  5 , Sandhi M Barreto  6 , Antonio L P Ribeiro  3 , G Neil Thomas  7 , Gregory Y H Lip  8 , Isabela M Bensenor  1   2 ; NIHR Global Health Research Group on Atrial Fibrillation Management  9 ; Ajini Arasalingam, Abi Beane, Isabela M Bensenor, Peter Brocklehurst, Kar Keung Cheng, Wahbi El-Bouri, Mei Feng, Alessandra C Goulart, Sheila Greenfield, Yutao Guo, Mahesan Guruparan, Gustavo Gusso, Tiffany E Gooden, Rashan Haniffa, Lindsey Humphreys, Kate Jolly, Sue Jowett, Balachandran Kumarendran, Emma Lancashire, Deirdre A Lane, Xuewen Li, Gregory Y H Lip Co-Pi, Yan-Guang Li, Trudie Lobban, Paulo A Lotufo, Semira Manseki-Holland, David J Moore, Krishnarajah Nirantharakumar, Rodrigo D Olmos, Elisabete Paschoal, Paskaran Pirasanth, Uruthirakumar Powsiga, Carla Romagnolli, Itamar S Santos, Alena Shantsila, Vethanayagam Antony Sheron, Kanesamoorthy Shribavan, Isabelle Szmigin, Kumaran Subaschandren, Rajendra Surenthirakumaran, Meihui Tai, G Neil Thomas Co-Pi, Ana C Varella, Hao Wang, Jingya Wang, Hui Zhang, Jiaoyue Zhong
Affiliations

Cardiovascular Health and Atrial Fibrillation or Flutter: A Cross-Sectional Study from ELSA-Brasil

[Article in Portuguese, English]
Itamar S Santos et al. Arq Bras Cardiol. .

Abstract
in English, Portuguese

Background: The association between ideal cardiovascular health (ICVH) status and atrial fibrillation or flutter (AFF) diagnosis has been less studied compared to other cardiovascular diseases.

Objective: To analyze the association between AFF diagnosis and ICVH metrics and scores in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Methods: This study analyzed data from 13,141 participants with complete data. Electrocardiographic tracings were coded according to the Minnesota Coding System, in a centralized reading center. ICVH metrics (diet, physical activity, body mass index, smoking, blood pressure, fasting plasma glucose, and total cholesterol) and scores were calculated as proposed by the American Heart Association. Crude and adjusted binary logistic regression models were built to analyze the association of ICVH metrics and scores with AFF diagnosis. Significance level was set at 0.05.

Results: The sample had a median age of 55 years and 54.4% were women. In adjusted models, ICVH scores were not significantly associated with prevalent AFF diagnosis (odds ratio [OR]:0.96; 95% confidence interval [95% CI]:0.80-1.16; p=0.70). Ideal blood pressure (OR:0.33; 95% CI:0.15-0.74; p=0.007) and total cholesterol (OR:1.88; 95% CI:1.19-2.98; p=0.007) profiles were significantly associated with AFF diagnosis.

Conclusions: No significant associations were identified between global ICVH scores and AFF diagnosis after multivariable adjustment in our analyses, at least partially due to the antagonistic associations of AFF with blood pressure and total cholesterol ICVH metrics. Our results suggest that estimating the prevention of AFF burden using global ICVH scores may not be adequate, and ICVH metrics should be considered in separate.

Fundamento: A associação entre o status de saúde cardiovascular ideal ( ideal cardiovascular health ( ICVH) e diagnóstico de fibrilação ou flutter atrial (FFA) foi menos estudado em comparação a outras doenças cardiovasculares.

Objetivos: Analisar a associação entre o diagnóstico de FFA e métricas e escores de ICVH no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil).

Métodos: Este estudo analisou dados de 13141 participantes com dados completos. Os traçados eletrocardiográficos foram codificados de acordo com o Sistema de Minnesota, em um centro de leitura centralizado. As métricas do ICVH (dieta, atividade física, índice de massa corporal, tabagismo, glicemia de jeju, e colesterol total) e escores do ICVH foram calculados conforme proposto pela American Heart Association . Modelos de regressão logística bruta e ajustada foram construídos para analisar associações de métricas e escores do ICVH com diagnóstico de FFA. O nível de significância foi estabelecido em 0,05.

Resultados: A idade mediana da amostra foi de 55 anos, e 54,4% eram mulheres. Nos modelos ajustados, os escores de ICVH não apresentaram associação significativa com diagnóstico de FFA prevalente [odds ratio (OR):0,96; intervalo de confiança de 95% (IC95%):0,80-1,16; p=0,70). Perfis de pressão arterial ideal (OR:0,33; IC95%:0,1-0,74; p=0,007) e colesterol total ideal (OR:1,88; IC95%:1,19-2,98; p=0,007) foram significativamente associados com o diagnóstico de FFA.

Conclusões: Não foram identificadas associações significativas entre escores de ICVH global e diagnóstico de FFA após ajuste multivariado em nossas análises, devido, ao menos em parte, às associações antagônicas da FFA com métricas de pressão arterial e de colesterol total do ICVH. Nossos resultados sugerem que estimar a prevenção da FFA por meio de escore de ICVH global pode não ser adequado, e as métricas do ICVH devem ser consideradas separadamente.

PubMed Disclaimer

Conflict of interest statement

Potencial conflito de interesse

Não há conflito com o presente artigo

Comment in

References

    1. Lloyd-Jones DM, Hong Y, Labarthe D, Mozaffarian D, Appel LJ, Van Horn L, et al. Defining and Setting National Goals for Cardiovascular Health Promotion and Disease Reduction: The American Heart Association’s strategic Impact Goal through 2020 and Beyond. Circulation. 2010;121(4):586–613. doi: 10.1161/CIRCULATIONAHA.109.192703. - DOI - PubMed
    1. Santos IS, Goulart AC, Pereira AC, Lotufo PA, Benseñor IM. Association between Cardiovascular Health Score and Carotid Intima-Media Thickness: Cross-Sectional Analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) Baseline Assessment. J Am Soc Echocardiogr. 2016;29(12):1207–1216.e4. doi: 10.1016/j.echo.2016.09.001. - DOI - PubMed
    1. Isiozor NM, Kunutsor SK, Voutilainen A, Kurl S, Kauhanen J, Laukkanen JA. Ideal Cardiovascular Health and Risk of Acute Myocardial Infarction Among Finnish Men. Atherosclerosis. 2019;289:126–131. doi: 10.1016/j.atherosclerosis.2019.08.024. - DOI - PubMed
    1. Corlin L, Short MI, Vasan RS, Xanthakis V. Association of the Duration of Ideal Cardiovascular Health Through Adulthood With Cardiometabolic Outcomes and Mortality in the Framingham Offspring Study. JAMA Cardiol. 2020;5(5):549–556. doi: 10.1001/jamacardio.2020.0109. - DOI - PMC - PubMed
    1. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, et al. Lifetime Risk for Development of Atrial Fibrillation: The Framingham Heart Study. Circulation. 2004;110(9):1042–1046. doi: 10.1161/01.CIR.0000140263.20897.42. - DOI - PubMed