title: A cohort study examination of established and emerging risk factors for atrial fibrillation: the Busselton Health Study.
abstract: Atrial fibrillation (AF) is the most common chronic arrhythmia in adults and its prevalence is increasing. Due to its serious cardiovascular complications there is a strong need to understand predisposing risk factors to develop effective prevention strategies. There are a few established risk factors but a number of further risk factors have been suggested including obesity, metabolic syndrome, sleep-disordered breathing, and inflammation. The aim of this study was to investigate established and emerging risk factors for AF in a cohort study of 4,267 adults in Busselton, Western Australia, without a history of AF at baseline in 1994/95 who were followed for 15 years for incident AF events. Baseline measurement included questionnaire, clinical assessment and blood sample. A total of 343 (8%) experienced AF during follow-up. Cox regression analysis confirmed advancing age, male sex, taller height, being on hypertension treatment and higher body mass index (BMI) as the major common risk factors (all p < 0.001). However, further modelling showed the effect of being on hypertension treatment may be stronger in women (p = 0.001) and the effect of BMI stronger in men (p = 0.004). After adjustment for these factors, no other factors were strongly related (p < 0.001) although short PR interval, history of valvular heart disease, stroke, chronic obstructive pulmonary disease, lung function and adiponectin level were marginally related (p < 0.05). This cohort study of predictors for incident AF has confirmed the major established risk factors. However, recently suggested potential novel risk factors for AF (inflammation, sleep-disordered breathing, glucose/metabolic disorders) were not confirmed in this study.
authors.affiliation: School of Population Health (M431), University of Western Australia, Crawley, WA, 6009, Australia, Matthew.knuiman@uwa.edu.au.
authors.forename: Matthew
authors.initials: M
authors.lastname: Knuiman
authors.forename: Tom
authors.initials: T
authors.lastname: Briffa
authors.forename: Mark
authors.initials: M
authors.lastname: Divitini
authors.forename: Derek
authors.initials: D
authors.lastname: Chew
authors.forename: John
authors.initials: J
authors.lastname: Eikelboom
authors.forename: Brendan
authors.initials: B
authors.lastname: McQuillan
authors.forename: Joseph
authors.initials: J
authors.lastname: Hung
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D001794:Blood Pressure; D015992:Body Mass Index; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*