Alonso A， Agarwal SK， Soliman EZ， Ambrose M， Chamberlain AM， Prineas RJ， Folsom AR.
Division of Epidemiology and Community Health， School of Public Health， University of Minnesota， 1300 S 2nd Street， Minneapolis， MN 55454. USA. aalogut@alumni.unav.es
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.
浏览PDF全文