Abstract
AimsObesity is a risk factor for several cardiovascular diseases (CVDs), including atrial fibrillation (AF). However, it is less clear whether overall fat or abdominal fat distribution are most important for risk of developing AF. This study investigates how different anthropometric measures correlate to the risk of developing clinical AF in the Malmö Diet and Cancer cohort (MDC-cohort).MethodsThe MDC-cohort (n = 25,961) was examined in 1991–1996. The endpoint was clinical AF diagnosed in a hospital setting, and retrieved via linkage with national registers. Hazard Ratios (HR) for incident AF was calculated in relation to quartiles of body mass index (BMI), waist circumference, waist hip ratio, waist height ratio, body fat percentage, weight and height, using Cox regression with adjustment for age, biological (e.g. blood pressure, diabetes, blood lipid levels), and socioeconomic risk factors.ResultsAfter adjustment for multiple risk factors, the risk of AF was significantly increased in the 4th versus 1st quartile of weight (HR for men/women = 2.02/1.93), BMI (HR = 1.62/1.52), waist circumference (HR = 1.67/1.63), waist to hip ratio (HR = 1.30/1.24), waist to height ratio (1.37/1.39) and body fat percentage (HR = 1.21/1.45) in men/women. Measures of overall weight (BMI, weight) were slightly more predictive than measures of abdominal obesity (waist hip ratio and waist height ratio) both in men and women.ConclusionAll measures of obesity were associated with increased risk of developing AF. Both overall obesity and abdominal obesity were related to incidence of AF in this population-based study, although the relationship for overall obesity was stronger.
Highlights
Obesity is an established risk factor for several cardiovascular diseases (CVDs) [1,2,3,4], including increased incidence of atrial fibrillation (AF) [5,6,7,8]
Obese individuals have a 50% increased risk of developing AF [5] and it has been estimated that a one-unit increase of mean body mass index (BMI) in the population could result in 6–8% more patients with
Men had higher prevalence of hypertension, smoking, diabetes, being married and had lower education compared to women. 2102 out of 9883 men and 2215 out of 16,078 women developed AF
Summary
Obesity is an established risk factor for several cardiovascular diseases (CVDs) [1,2,3,4], including increased incidence of atrial fibrillation (AF) [5,6,7,8]. Obesity increases total blood volume, which causes structural changes to the heart, such as left and right ventricular hypertrophy [13,14,15]. It leads to increased epi- and pericardial adipose tissue [16], which is associated with higher AF recurrence rate after ablation and higher burden of symptoms in patients with AF [6]. These structural changes alter cardiac electrical circuits, which could increase the risk of AF [13,14,15,16]
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