Liping Mou1, Faye L Norby2, Lin Y Chen3, Wesley T O'Neal4, Tené T Lewis5, Laura R Loehr6, Elsayed Z Soliman7, Alvaro Alonso8. 1. School of Public Health, Georgia State University, Atlanta (L.M.). 2. Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (F.L.N.). 3. Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis (L.Y.C.). 4. Division of Cardiology, Department of Medicine, School of Medicine (W.T.O.). 5. Department of Epidemiology, Rollins School of Public Health (T.T.L., A.A.). 6. Emory University, Atlanta, GA. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill (L.R.L.). 7. Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Wake Forest Medical School, Winston-Salem, NC (E.Z.S.). 8. Department of Epidemiology, Rollins School of Public Health (T.T.L., A.A.) alvaro.alonso@emory.edu.
Abstract
BACKGROUND: Limited information exists on the lifetime risk of atrial fibrillation (AF) in African Americans and by socioeconomic status. METHODS: We studied 15 343 participants without AF at baseline from the ARIC (Atherosclerosis Risk in Communities) cohort recruited in 1987 to 1989 from 4 communities in the United States when they were 45 to 64 years of age. Participants have been followed through 2014. Incidence rates of AF were calculated dividing the number of new cases by person-years of follow-up. Lifetime risk of AF was estimated by a modified Kaplan-Meier method considering death as a competing risk. Participants' family income and education were obtained at baseline. RESULTS: We identified 2760 AF cases during a mean follow-up of 21 years. Lifetime risk of AF was 36% (95% confidence interval, 32%-38%) in white men, 30% (95% confidence interval, 26%-32%) in white women, 21% (95% confidence interval, 13%-24%) in African American men, and 22% (95% confidence interval, 16%-25%) in African American women. Regardless of race and sex, incidence rates of AF decreased from the lowest to the highest categories of income and education. In contrast, lifetime risk of AF increased in individuals with higher income and education in most sex-race groups. Cumulative incidence of AF was lower in those with higher income and education compared with their low socioeconomic status counterparts through earlier life but was reversed after age 80. CONCLUSIONS: Lifetime risk of AF in the ARIC cohort was ≈1 in 3 among whites and 1 in 5 among African Americans. Socioeconomic status was inversely associated with cumulative incidence of AF before the last decades of life.
BACKGROUND: Limited information exists on the lifetime risk of atrial fibrillation (AF) in African Americans and by socioeconomic status. METHODS: We studied 15 343 participants without AF at baseline from the ARIC (Atherosclerosis Risk in Communities) cohort recruited in 1987 to 1989 from 4 communities in the United States when they were 45 to 64 years of age. Participants have been followed through 2014. Incidence rates of AF were calculated dividing the number of new cases by person-years of follow-up. Lifetime risk of AF was estimated by a modified Kaplan-Meier method considering death as a competing risk. Participants' family income and education were obtained at baseline. RESULTS: We identified 2760 AF cases during a mean follow-up of 21 years. Lifetime risk of AF was 36% (95% confidence interval, 32%-38%) in white men, 30% (95% confidence interval, 26%-32%) in white women, 21% (95% confidence interval, 13%-24%) in African American men, and 22% (95% confidence interval, 16%-25%) in African American women. Regardless of race and sex, incidence rates of AF decreased from the lowest to the highest categories of income and education. In contrast, lifetime risk of AF increased in individuals with higher income and education in most sex-race groups. Cumulative incidence of AF was lower in those with higher income and education compared with their low socioeconomic status counterparts through earlier life but was reversed after age 80. CONCLUSIONS: Lifetime risk of AF in the ARIC cohort was ≈1 in 3 among whites and 1 in 5 among African Americans. Socioeconomic status was inversely associated with cumulative incidence of AF before the last decades of life.
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