Incidence of atrial fibrillation in whites and African-Americans: the Atherosclerosis Risk in Communities (ARIC) study

Am Heart J. 2009 Jul;158(1):111-7. doi: 10.1016/j.ahj.2009.05.010.

Abstract

Objectives: To define the incidence and cumulative risk of atrial fibrillation (AF) in a population-based cohort of whites and African Americans.

Background: African-Americans reportedly have a lower risk of AF than whites despite their higher exposure to AF risk factors. However, precise estimates of AF incidence in African Americans have not been previously published.

Methods: We studied the incidence of AF in the Atherosclerosis Risk in Communities (ARIC) study, which has followed up 15,792 men and women 45 to 65 years of age at baseline from 4 communities in the United States since 1987. Atrial fibrillation cases were identified from electrocardiograms conducted at baseline and 3 follow-up visits, and from hospitalizations and death certificates through the end of 2004. During follow-up, 1,085 new cases of AF were identified (196 in African Americans, 889 in whites).

Results: Crude incidence rates of AF were 6.7, 4.0, 3.9, and 3.0 per 1,000 persons per year in white men, white women, African-American men, and African-American women, respectively. Increasing age was exponentially associated with an elevated risk of AF. Compared to whites, African-Americans had a 41% (95% CI: 8%-62%) lower age- and sex-adjusted risk of being diagnosed with AF. The cumulative risk of AF at 80 years of age was 21% in white men, 17% in white women, and 11% in African-American men and women.

Conclusion: In this population-based cohort, African Americans presented a lower risk of AF than whites. Still, the burden of AF among the former is substantial, with 1 in 9 receiving a diagnosis of AF before 80 years of age.

Publication types

  • Comparative Study

MeSH terms

  • African Americans / statistics & numerical data*
  • Atherosclerosis / epidemiology*
  • Atherosclerosis / ethnology*
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / ethnology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Electrocardiography
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Mass Screening
  • Middle Aged
  • Prospective Studies
  • Risk Assessment
  • Signal Processing, Computer-Assisted
  • United States