Prevalence of atrial fibrillation and association with clinical, sociocultural, and ancestral correlates among Hispanic/Latinos: The Hispanic Community Health Study/Study of Latinos

• Type of Material: Article
• Authors: Jered D. Linares, University of Chicago; Larry R. Jackson, II, Duke University; Farah Z. Dawood, University of California San Diego; Katrina Swett, Wake Forest University; Emelia J. Benjamin, Boston University; Neil Schneiderman, University of Miami; Elsayed Z. Soliman, Wake Forest University; Jianwen Cai, University of North Carolina; Alvaro Alonso, Emory University; Sylvia Wassertheil-Smoller, Albert Einstein College of Medicine; Gregory A. Talavera, San Diego State University; James P. Daubert, Duke University; Martha L. Daviglus, University of Chicago; Carlos J. Rodriguez, Wake Forest University
• Language: English
• Date: 2019-05-01
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 Heart Rhythm Society. All rights reserved.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.hrthm.2018.11.033
• Title of Journal or Parent Work: HEART RHYTHM
• Volume: 16
• Issue: 5
• Start Page: 686
• End Page: 693
• Grant/Funding Information: The Hispanic Community Health Study/Study of Latinos was supported by contracts from the National Heart, Lung, and Blood Institute to the University of North Carolina (grant no. N01-HC65233), the University of Miami (grant no. N01-HC65234), the Albert Einstein College of Medicine (grant no. N01-HC65235), Northwestern University (grant no.N01-HC65236), and San Diego State University (grant no. N01-HC65237). This study was partially supported by the National Institutes of Health/National Heart, Lung, and Blood Institute (grant nos. R01 HL104199 [principal investigator: Dr Rodriguez] and T32 HL125294 [principal investigator: Dr Daviglus]). Additional funding was provided by the American Heart Association (grant no. 16EIA26410001, to Dr Alonso).
• Keywords: DESIGN; STROKE; Science & Technology; Epidemiology; Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; Latinos; RACE-ETHNICITY; Clinical correlates; HYPERTENSION; HEART-DISEASE; CARDIOVASCULAR RISK-FACTORS; Hispanics; SCIENCE; Atrial fibrillation; ACCULTURATION; ADULTS; Cardiovascular System & Cardiology

Abstract

Background: Hispanics/Latinos represent the largest ethnic minority group in the United States. Atrial fibrillation (AF) is the most common cardiac arrhythmia in the United States. Objective: The purpose of this study was to provide data on the prevalence of AF and its correlates in a representative Hispanic/Latino population–based sample inclusive of all background groups. Methods: Hispanic Community Health Study/Study of Latinos participants (n=16,415; 60% women; 59% age >45 years) were enrolled between March 2008 and June 2011, representing individuals of Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American heritage. AF was defined by the 12-lead electrocardiogram and/or participant self-report of a physician diagnosis. Hispanic background–specific AF prevalence rates were determined. Weighted sequential logistic regression models were adjusted for demographic factors (age and sex) and clinical variables (diabetes, hypertension, body mass index, tobacco use, and estimated glomerular filtration rate). Results: The overall weighted prevalence of AF was 1.0% (n=162), with the highest prevalence in Hispanics of Dominican and Puerto Rican backgrounds (1.9% and 2.5% respectively) and the lowest in those of Mexican background (0.3%). Diabetes, hypertension, renal disease, left ventricular hypertrophy determined by the electrocardiogram, alcohol use, and English language preference (greater acculturation) (P <.01 for all) were significantly associated with higher AF prevalence. Multivariate analysis by Hispanic/Latino background group showed that Hispanics of Dominican and Puerto Rican backgrounds were at a 3- to 6-fold higher risk of AF than their Mexican counterparts. Conclusion: In a diverse representative population of Hispanics/Latinos, overall AF prevalence was low and varied significantly across Hispanic/Latino background groups independent of clinical or demographic factors.