Associations of Abdominal Obesity and New‐Onset Atrial Fibrillation in the General Population

Abstract

BackgroundHigher height and weight are known to be associated with higher risk of atrial fibrillation (AF); however, whether the risk of AF is related to abdominal obesity is unclear.Methods and ResultsWe studied 501 690 adults (mean age: 47.6±14.3 years; 250 664 women [50.0%]) without baseline AF in the National Sample Cohort released by the National Health Insurance Service in Korea. Body mass index (underweight defined as <18.5; normal, 18.5 to <25.0; overweight, 25.0 to <30.0; and obese, ≥30.0) and waist circumference (abdominal obesity defined as ≥90 cm for men and ≥80 cm for women) were evaluated. During a mean follow‐up of 3.9±1.3 years, 3443 participants (1432 women [41.6%]) developed AF. In multivariable models adjusted for clinical variables, the AF risk of underweight, overweight, and obese individuals increased by 21% (95% confidence interval, 1.01–1.45, P=0.043), 14% (95% confidence interval, 1.06–1.23, P<0.001), and 52% (95% confidence interval, 1.30–1.78, P<0.001), respectively, compared with those with normal body mass index. AF risk with confounder‐adjusted hazards for abdominal obesity was 18% (95% confidence interval, 1.10–1.27, P<0.001). The increased AF risk was present in abdominally obese individuals regardless of body mass index except for the obese group. In subgroup analysis, abdominal obesity by waist circumference conferred increased risk of new‐onset AF, particularly in participants without comorbidities.ConclusionsAbdominal obesity is an important, potentially modifiable risk factor for AF in nonobese Asian persons. These data suggest that interventions to decrease abdominal obesity may reduce the population burden of AF.

Metabolic Syndrome and the Risk of New-Onset Atrial Fibrillation in Middle-Aged East Asian Men

“…Previous Asian studies revealed that central obesity is a more significant risk factor for AF than general obesity (by BMI) 28 and increases the risk of AF regardless of BMI except for the obese group (BMI >30 kg/m 2 ). 29 Unlike previous studies, 7,8,15 however, we found that other components of MetS were not associated with the development of AF. HTN is a well-established risk factor for AF.…”

10-year nationwide trends of the incidence, prevalence, and adverse outcomes of non-valvular atrial fibrillation nationwide health insurance data covering the entire Korean population

“…This nationwide study was based on the national health claims database established by the NHIS of Korea. [10][11][12][13][14] An insured individual should pay a national health insurance, which is proportional to the individual's income. Although the user charge exists, it is mandatory for all Koreans to join the Korean NHIS.…”

Outcomes of Rate-Control Treatment in Patients With Atrial Fibrillation and Heart Failure ― A Nationwide Cohort Study ―

“…Indeed, for long-term AF management, the American College of Cardiology, American Heart Association, Heart Rhythm Society, and European Society of Cardiology all emphasize the impor-population of the Korean NHIS and consists of data from the beginning of 2002 through 2013. 2, 20 The database is a semi-dynamic cohort database; the cohort has been followed up to either the time of the participant's disqualification of health services due to death or emigration or to the end of the study period. Samples of newborn infants are included annually.…”