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

• Type of Material: Article
• Authors: Liping Mou, Georgia State University; Faye L. Norby, University of Minnesota; Lin Y. Chen, University of Minnesota; Wesley T. O'Neal, Emory University; Tene Lewis, Emory University; Laura R. Loehr, University of North Carolina; Elsayed Z. Soliman, Wake Forest University; Alvaro Alonso, Emory University
• Language: English
• Date: 2018-07-01
• Publisher: American Heart Association
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 American Heart Association, Inc.
• Final Published Version (URL): http://dx.doi.org/10.1161/CIRCEP.118.006350
• Title of Journal or Parent Work: Circulation: Arrhythmia and Electrophysiology
• ISSN: 1941-3149
• Volume: 11
• Issue: 7
• Start Page: e006350
• End Page: e006350
• Grant/Funding Information: This work was also supported by American Heart Association Grant 16EIA26410001 (Alonso).; The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institute of Health, Department of Health and Human Services, under contract nos. (HHSN268201700001I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I, HHSN268201700002I).
• Keywords: HEART-FAILURE; WHITES; Life Sciences & Biomedicine; EVENTS; Cardiac & Cardiovascular Systems; AFRICAN-AMERICANS; stroke; atrial fibrillation; income; ASSOCIATION; PREVALENCE; incidence; atherosclerosis; Science & Technology; Cardiovascular System & Cardiology; POPULATION; MORTALITY; HISPANICS; CARDIOVASCULAR-DISEASE
• Research Categories: Sociology, Ethnic and Racial Studies; Health Sciences, Public Health; Health Sciences, Epidemiology

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.