Metabolic syndrome and incidence of atrial fibrillation among blacks and whites in the Atherosclerosis Risk in Communities (ARIC) Study

• Type of Material: Article
• Authors: Joseph J. Decker, University of Minnesota; Faye L. Norby, University of Minnesota; Mark R. Rooney, University of Minnesota; Elsayed Z. Soliman, Wake Forest University; Pamela L. Lutsey, University of Minnesota; James S. Pankow, University of Minnesota; Alvaro Alonso, Emory University; Lin Y. Chen, University of Minnesota
• Language: English
• Date: 2010-05-01
• Publisher: MOSBY-ELSEVIER
• Publication Version: Final Published Version
• Copyright Statement: © 2010 Mosby, Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ahj.2010.02.005
• Title of Journal or Parent Work: AMERICAN HEART JOURNAL
• Volume: 159
• Issue: 5
• Start Page: 850
• End Page: 856
• Grant/Funding Information: Dr. Chen receives grant support from the National Heart, Lung and Blood Institute (R01HL126637 and R01HL141288). Dr. Alonso was supported by American Heart Association grant 16EIA26410001. Ms. Rooney was supported by the National Heart, Lung and Blood Institute grant T32HL007779.; 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 Institutes of Health, Department of Health and Human Services, under Contract nos. (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I).
• Keywords: HYPERTENSION; FLUTTER; MANAGEMENT; Science & Technology; Life Sciences & Biomedicine; INDEPENDENT RISK; DIABETES-MELLITUS; Cardiac & Cardiovascular Systems; IMPACT; OBESITY; Cardiovascular System & Cardiology; STROKE; PREDICTORS; PREVALENCE
• Research Categories: Health Sciences, Medicine and Surgery; Health Sciences, Public Health

Abstract

Background: The metabolic syndrome (MetSyn) has been implicated in the development of atrial fibrillation (AF); however, knowledge of this association among blacks is limited. Methods: We determined the risk of incident AF through December 2005 in relation to baseline (1987-1989) MetSyn status in 15,094 participants of the Atherosclerosis Risk in Communities study. Results: Over a mean follow-up of 15.4 years, 1,238 incident AF events were identified. The hazard ratio (HR) for AF among individuals with, compared to those without, the MetSyn was 1.67 (95% CI 1.49-1.87), and associations did not differ by race (P for interaction = .73). The population attributable risk of AF from the MetSyn was 22%. The multivariable-adjusted HRs (95% CI) for each MetSyn component were 1.95 (1.72-2.21) (elevated blood pressure), 1.40 (1.23-1.59) (elevated waist circumference), 1.20 (1.06-1.37) (low high-density lipoprotein cholesterol), 1.16 (1.03-1.31) (impaired fasting glucose), and 0.95 (0.84-1.09) (elevated triglycerides). A monotonically increasing risk of AF with increasing number of MetSyn components was observed, with an HR of 4.40 (95% CI 3.25-5.94) for those with all 5 MetSyn components compared to those with 0 components. Conclusion: In this large cohort, the MetSyn and most of its components were associated with a higher risk of AF in both blacks and whites. Given the high prevalence of the MetSyn, strategies to prevent its development or to control individual components may reduce the burden of AF.