African American Race and Prevalence of Atrial Fibrillation:A Meta-Analysis

Abstract

Background. It has been observed that African American race is associated with a lower prevalence of atrial fibrillation (AF) compared to Caucasian race. To better quantify the association between African American race and AF, we performed a meta-analysis of published studies among different patient populations which reported the presence of AF by race. Methods. A literature search was conducted using electronic databases between January 1999 and January 2011. The search was limited to published studies in English conducted in the United States, which clearly defined the presence of AF in African American and Caucasian subjects. A meta-analysis was performed with prevalence of AF as the primary endpoint. Results. In total, 10 studies involving 1,031,351 subjects were included. According to a random effects analysis, African American race was associated with a protective effect with regard to AF as compared to Caucasian race (odds ratio 0.51, 95% CI 0.44 to 0.59, P < 0.001). In subgroup analyses, African American race was significantly associated with a lower prevalence of AF in the general population, those hospitalized or greater than 60 years old, postcoronary artery bypass surgery patients, and subjects with heart failure. Conclusions. In a broad sweep of subjects in the general population and hospitalized patients, the prevalence of AF in African Americans is consistently lower than in Caucasians.

Epidemiology of atrial fibrillation

“…A meta‐analysis of 10 studies examining the prevalence of AF among African‐Americans in the USA compared with Whites, concluded that being African‐American was associated with a “protective effect” from AF (OR 0.51, 95% CI 0.44‐0.59, P < .001). Despite the lower prevalence of AF, African‐Americans in the USA have twice the risk of first ever stroke compared with Whites …”

Epidemiology of Arrhythmias and Conduction Disorders in Older Adults

“…[43] The authors found that the overall prevalence of AF was higher in men than in women for all age groups, but because there were almost twice the number of women than men >75 years in the general population, the absolute numbers of women and men with AF were similar. A recent meta-analysis[44] of 10 studies involving 1,031,351 subjects found a markedly lower prevalence of AF in African Americans compared to Caucasians (OR 0.51, 95%CI 0.44 – 0.59, P<0.001) in both the general population and in those over 60 years of age.…”

Rarity of Heart Failure in a Traditional African Population. A Rural Community Based Study

“…Atrial fibrillation is not common in African populations, either native on the continent or in the America [19]. There must be a genetic angle to it as African Americans are less encumbered than white Americans [20]. The low prevalence of established risks already alluded to here may be why African rural populations [21] have a strikingly low rate of atrial fibrillation than urban African and western populations.…”