Atrial Fibrillation: Its Prevalence and Risk Factor Profile in the German General Population

Overview

Journal Dtsch Arztebl Int

Specialties General Medicine
Public Health

Date 2012 May 12

PMID 22577476

Citations 46

Authors

Renate B Schnabel

Sandra Wilde

Philipp S Wild

Thomas Munzel

Stefan Blankenberg

Affiliations

Soon will be listed here.

Abstract

Background: Atrial fibrillation (AF) is an increasingly common problem in primary care, but little is known about its prevalence and the distribution of AF risk factors in the general population.

Methods: We determined the prevalence of AF and the distribution of known AF risk factors among persons participating in the population-based Gutenberg Health Study. To this end, we used interview data about the medical diagnosis of AF and electrocardiograms (ECGs) that were performed for the study in 5000 persons aged 35 to 74. The response rate was 60.4%.

Results: There were 5000 persons in the study sample (age 52.2 ± 11 years; 50.6% were women). The prevalence of AF, weighted for the age and sex distribution of the general population, was 2.5%. AF was found to be more common in older persons, with a more pronounced increase in men: whereas its prevalence was 0.7% in 35- to 44-year-old men, the corresponding figure for the age group 65- to 74 was as high as 10.6%. Twenty five participants (15.5% of AF cases) received their initial diagnosis of AF on the basis of the study ECG. Compared to persons without AF, persons with AF were older and more commonly male, and they had a higher burden of cardiovascular risk factors. 14.3% of persons with AF had none of the well-established risk factors for AF (systolic blood pressure, antihypertensive medication, increased body-mass-index, heart failure). 42.7% of persons with AF were not taking either anticoagulants or platelet inhibitors.

Conclusion: These data indicate that the prevalence of AF in the middle-aged general population is 2.5% overall, and higher in the elderly. AF is thus a significant public health problem, and greater awareness of it is needed.

Citing Articles

High-Intensity Interval Training vs. Medium-Intensity Continuous Training in Cardiac Rehabilitation Programs: A Narrative Review.

Costache A, Mastaleru A, Leon M, Roca M, Gavril R, Cosau D Medicina (Kaunas). 2024; 60(11).

PMID: 39597060 PMC: 11596889. DOI: 10.3390/medicina60111875.

Relationship between Pharmacological Treatment Strategy and Cognitive Function in Geriatric Patients with Atrial Fibrillation.

Goetze M, Knauf T, Ebelt H J Clin Med. 2023; 12(24).

PMID: 38137793 PMC: 10743707. DOI: 10.3390/jcm12247724.

[Prevalence, incidence and predictive factors of atrial fibrillation in geriatric patients-A prospective observational study].

Gotze M, Ebelt H Z Gerontol Geriatr. 2023; 57(2):120-125.

PMID: 37084091 DOI: 10.1007/s00391-023-02177-0.

Noise annoyance and risk of prevalent and incident atrial fibrillation-A sex-specific analysis.

Hahad O, Beutel M, Gilan D, Chalabi J, Schuster A, Gianicolo E Front Public Health. 2022; 10:1061328.

PMID: 36536776 PMC: 9758722. DOI: 10.3389/fpubh.2022.1061328.

Lower levels of vWF are associated with lower risk of cardiovascular disease.

van Paridon P, Panova-Noeva M, Van Oerle R, Schulz A, Prochaska J, Arnold N Res Pract Thromb Haemost. 2022; 6(7):e12797.

PMID: 36381288 PMC: 9637545. DOI: 10.1002/rth2.12797.

References

Ford E, Ajani U, Croft J, Critchley J, Labarthe D, Kottke T . Explaining the decrease in U.S. deaths from coronary disease, 1980-2000. N Engl J Med. 2007; 356(23):2388-98. DOI: 10.1056/NEJMsa053935. View

Schnabel R, Schulz A, Wild P, Sinning C, Wilde S, Eleftheriadis M . Noninvasive vascular function measurement in the community: cross-sectional relations and comparison of methods. Circ Cardiovasc Imaging. 2011; 4(4):371-80. DOI: 10.1161/CIRCIMAGING.110.961557. View

Schnabel R, Larson M, Yamamoto J, Sullivan L, Pencina M, Meigs J . Relations of biomarkers of distinct pathophysiological pathways and atrial fibrillation incidence in the community. Circulation. 2010; 121(2):200-7. PMC: 3224826. DOI: 10.1161/CIRCULATIONAHA.109.882241. View

Dormann H, Diesch K, Ganslandt T, Hahn E . Numerical parameters and quality indicators in a medical emergency department. Dtsch Arztebl Int. 2010; 107(15):261-7. PMC: 2864440. DOI: 10.3238/arztebl.2010.0261. View

Meinertz T, Kirch W, Rosin L, Pittrow D, Willich S, Kirchhof P . Management of atrial fibrillation by primary care physicians in Germany: baseline results of the ATRIUM registry. Clin Res Cardiol. 2011; 100(10):897-905. PMC: 3178025. DOI: 10.1007/s00392-011-0320-5. View

Lip G, Frison L, Halperin J, Lane D . Identifying patients at high risk for stroke despite anticoagulation: a comparison of contemporary stroke risk stratification schemes in an anticoagulated atrial fibrillation cohort. Stroke. 2010; 41(12):2731-8. DOI: 10.1161/STROKEAHA.110.590257. View

Nabauer M, Gerth A, Limbourg T, Schneider S, Oeff M, Kirchhof P . The Registry of the German Competence NETwork on Atrial Fibrillation: patient characteristics and initial management. Europace. 2009; 11(4):423-34. PMC: 2659602. DOI: 10.1093/europace/eun369. View

Wang T, Larson M, Levy D, Vasan R, Leip E, Wolf P . Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation. 2003; 107(23):2920-5. DOI: 10.1161/01.CIR.0000072767.89944.6E. View

Schnabel R, Aspelund T, Li G, Sullivan L, Suchy-Dicey A, Harris T . Validation of an atrial fibrillation risk algorithm in whites and African Americans. Arch Intern Med. 2010; 170(21):1909-17. PMC: 3021784. DOI: 10.1001/archinternmed.2010.434. View

10.

Psaty B, Manolio T, Kuller L, Kronmal R, Cushman M, Fried L . Incidence of and risk factors for atrial fibrillation in older adults. Circulation. 1997; 96(7):2455-61. DOI: 10.1161/01.cir.96.7.2455. View

11.

Aliot E, Breithardt G, Brugada J, Camm J, Lip G, Vardas P . An international survey of physician and patient understanding, perception, and attitudes to atrial fibrillation and its contribution to cardiovascular disease morbidity and mortality. Europace. 2010; 12(5):626-33. PMC: 2859877. DOI: 10.1093/europace/euq109. View

12.

Gage B, Waterman A, Shannon W, Boechler M, Rich M, Radford M . Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001; 285(22):2864-70. DOI: 10.1001/jama.285.22.2864. View

13.

Holstenson E, Ringborg A, Lindgren P, Coste F, Diamand F, Nieuwlaat R . Predictors of costs related to cardiovascular disease among patients with atrial fibrillation in five European countries. Europace. 2010; 13(1):23-30. DOI: 10.1093/europace/euq325. View

14.

Currie C, Jones M, Goodfellow J, McEwan P, Morgan C, Emmas C . Evaluation of survival and ischaemic and thromboembolic event rates in patients with non-valvar atrial fibrillation in the general population when treated and untreated with warfarin. Heart. 2005; 92(2):196-200. PMC: 1860757. DOI: 10.1136/hrt.2004.058339. View

15.

Trappe H . Atrial fibrillation: established and innovative methods of evaluation and treatment. Dtsch Arztebl Int. 2012; 109(1-2):1-7. PMC: 3265980. DOI: 10.3238/arztebl.2012.0001. View

16.

Hart R, Pearce L, Aguilar M . Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007; 146(12):857-67. DOI: 10.7326/0003-4819-146-12-200706190-00007. View

17.

Benjamin E, Wolf P, DAgostino R, Silbershatz H, Kannel W, Levy D . Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998; 98(10):946-52. DOI: 10.1161/01.cir.98.10.946. View

18.

Stefansdottir H, Aspelund T, Gudnason V, Arnar D . Trends in the incidence and prevalence of atrial fibrillation in Iceland and future projections. Europace. 2011; 13(8):1110-7. DOI: 10.1093/europace/eur132. View

19.

Benjamin E, Levy D, Vaziri S, DAgostino R, Belanger A, Wolf P . Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA. 1994; 271(11):840-4. View

20.

Miyasaka Y, Barnes M, Gersh B, Cha S, Bailey K, Abhayaratna W . Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006; 114(2):119-25. DOI: 10.1161/CIRCULATIONAHA.105.595140. View