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Cardiovascular medicine
Research
Prevalence of atrial fibrillation and cardiovascular risk factors in a 63–65 years old general population cohort: the Akershus Cardiac Examination (ACE) 1950 Study
  1. Trygve Berge1,2,
  2. Magnus Nakrem Lyngbakken2,3,
  3. Håkon Ihle-Hansen1,2,
  4. Jon Brynildsen2,3,
  5. Mohammad Osman Pervez2,3,
  6. Erika Nerdrum Aagaard2,3,
  7. Thea Vigen2,3,
  8. Brede Kvisvik2,3,
  9. Ingrid Elisabeth Christophersen1,
  10. Kjetil Steine2,3,
  11. Torbjørn Omland2,3,
  12. Pål Smith2,3,
  13. Helge Røsjø2,3,
  14. Arnljot Tveit1,2
  1. 1 Department of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Gjettum, Norway
  2. 2 Institute of Clinical Medicine, University of Oslo, Oslo, Norway
  3. 3 Division of Medicine, Akershus University Hospital, Lorenskog, Norway
  1. Correspondence to Dr Trygve Berge; trygve.berge{at}vestreviken.no

Abstract

Objectives To investigate the sex-specific prevalence of atrial fibrillation (AF), including subclinical AF found by screening in a general population aged 63–65 years. The prevalence of cardiovascular risk factors and their association with AF will also be investigated.

Design Cross-sectional analysis of an observational, prospective, longitudinal, population-based cohort study.

Setting General population in Akershus county, Norway.

Participants Women and men born in 1950. We included 3706 of 5827 eligible individuals (63.6%); 48.8% were women.

Methods All participants underwent extensive cardiovascular examinations, including 12-lead ECG. History of AF and other cardiovascular diseases were self-reported. Subsequent validation of all reported or detected AF diagnoses was performed.

Results Mean age was 63.9±0.7 years. Prevalence of ECG-verified AF was 4.5% (women 2.4%, men 6.4%; p<0.001), including screen-detected AF in 0.3% (women 0.1%, men 0.6%; p<0.01). Hypertension was found in 62.0% (women 57.8%, men 66.0%; p<0.001). Overweight or obesity was found in 67.6% (women 59.8%, men 74.9%; p<0.001). By multivariate logistic regression, risk factors associated with AF were height (OR 1.67 per 10 cm; 95% CI 1.26 to 2.22; p<0.001), weight (OR 1.15 per 10 kg; 95% CI 1.01 to 1.30; p=0.03), hypertension (OR 2.49; 95% CI 1.61 to 3.86; p<0.001), heart failure (OR 3.51; 95% CI 1.71 to 7.24; p=0.001), reduced estimated glomerular filtration rate (OR 2.56; 95% CI 1.42 to 4.60; p<0.01) and at least one first-degree relative with AF (OR 2.32; 95% CI 1.63 to 3.31; p<0.001), whereas male sex was not significantly associated (OR 1.00; 95% CI 0.59 to 1.68; p=0.99).

Conclusion In this cohort from the general population aged 63–65 years, we found a higher prevalence of known AF than previously reported below the age of 65 years. The additional yield of single time point screening for AF was low. Body size and comorbidity may explain most of the sex difference in AF prevalence at this age.

Trial registration number NCT01555411; Results.

  • atrial fibrillation
  • obesity
  • cardiovascular risk
  • prevalence
  • screening
  • cardiac epidemiology

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-021704

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    Footnotes

    • Contributors TB, KS, TO, PS, HR and AT designed the study. TB, MNL, HI-H, JB, MOP, ENA, TV, BK and IEC have performed the baseline examinations and the acquisition of data. TB and PS have performed the validation of atrial fibrillation diagnoses, supported by MNL, JB and AT. TB and MNL have performed the statistical analysis. TB has written the manuscript. AT was the principal investigator (PI) and HR was the co-PI of the study. All authors have revised the manuscript for important intellectual content and have read and approved the final manuscript.

    • Funding This work was supported by the non-governmental patient organisation Norwegian Health Association (‘Nasjonalforeningen for folkehelsen’), Vestre Viken Hospital Trust and Akershus University Hospital.

    • Competing interests TB has (outside this work) received honoraria from Boehringer-Ingelheim, Bayer and Pfizer/Bristol-Myers Squibb. TO has (outside this work) received honoraria or research support from Abbott, AstraZeneca, Bayer, Novartis, Roche, Singulex and Thermo Fisher. HR has (outside this work) received honoraria or research support from Novartis, CardiNor AS and SpinChip Diagnostics. TO and HR are partners in a patent filed by the University of Oslo regarding the use of secretoneurin as a biomarker in patients with cardiovascular disease and patients with critical illness.

    • Patient consent Obtained.

    • Ethics approval Regional Ethics Committee, South-East Norway (ref. 2011/1475).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The data set used in this study is not publicly available, as the Data Protection Authority approval and patient consent do not allow for such publication. However, the study group welcomes initiatives for cooperation, and data access may be granted upon application. More information on: www.ace1950.no.