Risk factors for atrial fibrillation in population-based studies : Epidemiological perspectives

University dissertation from Faculty of Medicine, Lund University

Abstract: Atrial fibrillation (AF) is common among the elderly, and has serious consequences such as stroke and increased mortality. Not all of the population attributable risk for AF is explained by known risk factors. This thesis used epidemiological methods and two population based cohorts- the Malmö Preventive project (MPP) and the HOMA sub study of the Malmö Diet and Cancer Study (MDCS)- to analyse the associations between lung volumes and AF, (Paper I), fasting plasma insulin (FPI) and AF (Paper II), supraventricular activity and AF (Paper III), and the rate of change over six years of several known AF risk factors and incident AF (Paper IV). There was an independent association between FEV1 and AF, in the total population and across sub-groups of male and female smokers and non-smokers in the MPP.Low FPI was independently associated with increased risk of AF among men. Supraventricular activity was associated with increased risk of AF in the HOMA cohort. The rates of increase of systolic blood pressure (SBP), fasting blood glucose (FBG), and weight were independently associated with incident AF among men in the MPP, irrespective of the baseline value of these variables.The conclusion of this thesis is to propose that FEV1, FPI, supraventricular activity and the rates of change of SBP, FBG and weight in mid-life could be novel risk factors for AF.