Trends in burden of atrial fibrillation over three decades: a population-based study.

IF 4.4 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Heart Pub Date : 2025-09-27 DOI:10.1136/heartjnl-2025-326510

Shuyue Yang, Nicole De Kruijf, Fang Zhu, Julie Anne Eni van Oortmerssen, Natasja M S de Groot, Maryam Kavousi

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引用次数: 0

Abstract

Background: Atrial fibrillation (AF) is a common sustained cardiac arrhythmia with increasing prevalence and incidence worldwide. However, long-term trends in AF prevalence, incidence, associated risk factors, and the role of comorbidities, including sex-specific differences is limited.

Methods: We included 7750, 7675, and 7121 participants from the population-based Rotterdam Study across three epochs over 3 decades (epoch 1990s: 1989-1993; epoch 2000s: 1997-2001; and epoch 2010s: 2009-2014). We examined trends in incidence rates and estimated incidence rate ratios (IRRs) over time, both overall and stratified by sex. Cox regression were applied to evaluate associations between comorbidities and incident AF to derive HRs with 95% CIs. Population attributable fractions (PAFs) were calculated to quantify the contribution of key comorbidities to AF incidence.

Results: The mean (SD) of age in three epochs was around 70 years (epoch 1990s: 70.3 (9.6), epoch 2000s: 70.0 (8.7) and epoch 2010s: 70.4 (9.8)). The follow-up for each participant was 5 years. The age and sex-adjusted AF incidence rates in three epochs were 36.1, 27.4 and 52.0 per 1000 person-years. The AF incidence rates were 31.4, 22.9 and 44.1 for women and 45.0, 34.7 and 65.6 for men, respectively. Hypertension was the most important contributor to incident AF in all three epochs (PAFs were epoch 1990s: 36.0% (95% CI 24.3% to 54.2%), epoch 2000s: 35.0% (95% CI 14.0% to 59.5%) and epoch 2010s: 42.7% (95% CI 22.6% to 61.0%)), especially in women (epoch 1990s: 46.6% (95% CI 24.0% to 68.3%), epoch 2000s: 38.60% (95% CI 11.9% to 68.9%) and epoch 2010s: 59.9% (95% CI 40.5% to 82.5%)).

Conclusion: The increasing burden of AF over the last three decades for both women and men calls for improved sex-specific AF prevention and management strategies. Hypertension remains to be a principal contributor to the population burden of AF, in particular among women. Effective sex-specific management of hypertension is a promising target in AF prevention strategies.

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三十年来房颤负担的趋势：一项基于人群的研究。

背景：房颤（AF）是一种常见的持续性心律失常，在世界范围内的患病率和发病率都在不断上升。然而，房颤患病率、发病率、相关危险因素和合并症的作用（包括性别差异）的长期趋势是有限的。方法：我们从基于人群的鹿特丹研究中纳入了7750、7675和7121名参与者，跨越30年的三个时期（1990年代：1989-1993年；2000年代：1997-2001年；2010年代：2009-2014年）。我们检查了发病率趋势和估计发病率比（IRRs）随时间的变化，包括总体和按性别分层。采用Cox回归评估合并症与AF事件之间的关系，得出95% ci的hr。计算人群归因分数（paf）来量化关键合并症对房颤发病率的贡献。结果：3个时期的平均年龄（SD）在70岁左右(90年代：70.3(9.6)，2000年代：70.0（8.7)，2010年代：70.4(9.8)）。每位参与者的随访时间为5年。三个时期经年龄和性别调整的房颤发病率分别为36.1、27.4和52.0 / 1000人-年。女性的发病率分别为31.4、22.9和44.1，男性为45.0、34.7和65.6。高血压是所有三个时期AF发生的最重要因素(paf为1990年代：36.0% (95% CI 24.3%至54.2%)，2000年代：35.0% （95% CI 14.0%至59.5%）和2010年代：42.7% (95% CI 22.6%至61.0%))，尤其是女性(1990年代：46.6% （95% CI 24.0%至68.3%)，2000年代：38.60% （95% CI 11.9%至68.9%）和2010年代：59.9% (95% CI 40.5%至82.5%)）。结论：在过去的30年里，房颤的负担对男性和女性都在增加，需要改进针对性别的房颤预防和管理策略。高血压仍然是房颤人群负担的主要因素，特别是在女性中。有效的性别特异性高血压管理是房颤预防策略的一个有希望的目标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart 医学-心血管系统

CiteScore

10.30

自引率

5.30%

发文量

320

审稿时长

3-6 weeks

期刊介绍： Heart is an international peer reviewed journal that keeps cardiologists up to date with important research advances in cardiovascular disease. New scientific developments are highlighted in editorials and put in context with concise review articles. There is one free Editor’s Choice article in each issue, with open access options available to authors for all articles. Education in Heart articles provide a comprehensive, continuously updated, cardiology curriculum.