Premium
Racial Differences in the Incidence of and Risk Factors for Atrial Fibrillation in Older Adults: The Cardiovascular Health Study
Author(s) -
Jensen Paul N.,
Thacker Evan L.,
Dublin Sascha,
Psaty Bruce M.,
Heckbert Susan R.
Publication year - 2013
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.12085
Subject(s) - medicine , hazard ratio , atrial fibrillation , incidence (geometry) , confidence interval , demography , proportional hazards model , risk factor , lower risk , relative risk , cardiology , physics , sociology , optics
This study examined whether different associations between risk factors and atrial fibrillation ( AF ) according to race could explain the lower incidence of AF in blacks. Baseline risk factor information was obtained from interviews, clinical examinations, and echocardiography in 4,774 white and 911 black C ardiovascular H ealth S tudy participants aged 65 and older without a history of AF at baseline in 1989/90 or 1992/93. Incident AF was determined according to hospital discharge diagnosis or annual study electrocardiogram. Cox regression was used to assess associations between risk factors and race and incident AF . During a mean 11.2 years of follow‐up, 1,403 whites and 182 blacks had incident AF . Associations between all examined risk factors were similar in both races, except left ventricular posterior wall thickness, which was more strongly associated with AF in blacks (per 0.2 cm, blacks: hazard ratio ( HR ) = 1.72, 95% confidence interval ( CI ) = 1.44–2.06; whites: HR = 1.30, 95% CI = 1.18–1.43). Overall, the relative risk of AF was 25% lower in blacks than whites after adjustment for age and sex ( HR = 0.75, 95% CI = 0.64–0.87) and 45% lower after adjustment for all considered risk factors ( HR = 0.55, 95% CI = 0.35–0.88). Different associations of the considered risk factors and incident AF by race do not explain the lower incidence of AF in blacks.