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

Alvaro Alonso, Sunil K. Agarwal, Elsayed Z. Soliman, Marietta Ambrose, Alanna Chamberlain, Ronald J. Prineas, Aaron R. Folsom

Research output: Contribution to journalArticle

288 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)111-117
Number of pages7
JournalAmerican Heart Journal
Volume158
Issue number1
DOIs
StatePublished - Jul 1 2009
Externally publishedYes

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African Americans
Atrial Fibrillation
Atherosclerosis
Incidence
Death Certificates
Population
Electrocardiography
Hospitalization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Incidence of atrial fibrillation in whites and African-Americans : The Atherosclerosis Risk in Communities (ARIC) study. / Alonso, Alvaro; Agarwal, Sunil K.; Soliman, Elsayed Z.; Ambrose, Marietta; Chamberlain, Alanna; Prineas, Ronald J.; Folsom, Aaron R.

In: American Heart Journal, Vol. 158, No. 1, 01.07.2009, p. 111-117.

Research output: Contribution to journalArticle

Alonso, Alvaro ; Agarwal, Sunil K. ; Soliman, Elsayed Z. ; Ambrose, Marietta ; Chamberlain, Alanna ; Prineas, Ronald J. ; Folsom, Aaron R. / Incidence of atrial fibrillation in whites and African-Americans : The Atherosclerosis Risk in Communities (ARIC) study. In: American Heart Journal. 2009 ; Vol. 158, No. 1. pp. 111-117.
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N2 - 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.

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