Eitaro Kodani1,2, Tomohiro Kaneko3, Hitomi Fujii4,2, Hiroyuki Nakamura2, Hajime Sasabe2, Yutaka Tamura2, Wataru Shimizu5. 1. Department of Internal Medicine and Cardiology, Nippon Medical School Tama-Nagayama Hospital. 2. TAMA CITY Medical Association. 3. Department of Nephrology, Nippon Medical School Tama-Nagayama Hospital. 4. Tama-center Mirai Clinic. 5. Department of Cardiovascular Medicine, Nippon Medical School.
Abstract
BACKGROUND: Although National Health Insurance special health checkups have been useful for the diagnosis of metabolic syndrome, they are insufficient to identify atrial fibrillation (AF). In Tama City in Tokyo, 12-lead electrocardiogram has been included as an essential examination in special health checkups to diagnose AF since 2008. Methods and Results: In subjects aged 40-74 years at entry, prevalence of AF was 0.8% (men, 1.7%; women, 0.2%) in 2008 and 1.4% (men, 2.9%; women, 0.4%) in 2015. Of 10,430 subjects without AF in 2008 (mean age, 64.9±7.1 years; men, 40.4%), AF developed in 133 between 2008 and 2015. The incidence rate of new-onset AF was 2.5/1,000 person-years during an observation period of 52,707 person-years. On multivariate Cox regression analysis in subjects without a history of cardiac disease, hypertension (HR, 1.58; 95% CI: 1.01-2.47, P=0.045) and body mass index (BMI; /1-kg/m2increase; HR, 1.07; 95% CI: 1.00-1.12, P=0.049) were significant risk factors for new-onset AF in addition to age and male sex. CONCLUSIONS: Prevalence of AF increased between 2008 and 2015. Age, male sex, hypertension, and BMI were significant predictors for future incidence of AF in the general population without overt cardiac disease. Controlling hypertension and BMI may prevent new-onset AF in the general population.
BACKGROUND: Although National Health Insurance special health checkups have been useful for the diagnosis of metabolic syndrome, they are insufficient to identify atrial fibrillation (AF). In Tama City in Tokyo, 12-lead electrocardiogram has been included as an essential examination in special health checkups to diagnose AF since 2008. Methods and Results: In subjects aged 40-74 years at entry, prevalence of AF was 0.8% (men, 1.7%; women, 0.2%) in 2008 and 1.4% (men, 2.9%; women, 0.4%) in 2015. Of 10,430 subjects without AF in 2008 (mean age, 64.9±7.1 years; men, 40.4%), AF developed in 133 between 2008 and 2015. The incidence rate of new-onset AF was 2.5/1,000 person-years during an observation period of 52,707 person-years. On multivariate Cox regression analysis in subjects without a history of cardiac disease, hypertension (HR, 1.58; 95% CI: 1.01-2.47, P=0.045) and body mass index (BMI; /1-kg/m2increase; HR, 1.07; 95% CI: 1.00-1.12, P=0.049) were significant risk factors for new-onset AF in addition to age and male sex. CONCLUSIONS: Prevalence of AF increased between 2008 and 2015. Age, male sex, hypertension, and BMI were significant predictors for future incidence of AF in the general population without overt cardiac disease. Controlling hypertension and BMI may prevent new-onset AF in the general population.
Entities:
Keywords:
Atrial fibrillation; General population; Health checkup; Incidence; Prevalence