Open AccessTemporal Trends in Incidence, Prevalence, and Mortality of Atrial Fibrillation in Primary Care
Author(s) -
Lane Deirdre A.,
Skjøth Flemming,
Lip Gregory Y. H.,
Larsen Torben B.,
Kotecha Dipak
Publication year - 2017
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.116.005155
Subject(s) - medicine , atrial fibrillation , incidence (geometry) , stroke (engine) , diabetes mellitus , population , pediatrics , demography , mortality rate , epidemiology , mechanical engineering , physics , environmental health , endocrinology , sociology , optics , engineering
Background Incidence and prevalence of atrial fibrillation ( AF ) are expected to increase dramatically; however, we currently lack comprehensive data on temporal trends in unselected clinical populations. Methods and Results Analysis of the UK Clinical Practice Research Datalink ( CPRD ) from 1998 to 2010 of patients with incident AF , excluding major valvular disease, linked to hospital admission data and national statistics. Fifty‐seven thousand eight hundred eighteen adults were identified with mean age 74.2 ( SD , 11.7) years and 48.3% women. Overall age‐adjusted incidence of AF per 1000 person years was 1.11 (95% CI , 1.09–1.13) in 1998–2001, 1.33 (1.31–1.34) in 2002–2006, and 1.33 (1.31–1.35) in 2007–2010. Ongoing increases in incidence were noted for patients aged ≥75 years, with similar temporal patterns in women and men. Associated comorbidities varied over time, with a constant prevalence of previous stroke, increases in hypertension and diabetes mellitus, and decreases in ischemic heart disease. Among patients aged 55 to 74 years, there was a significant reduction in mortality over time ( P <0.001), but mortality rates in patients aged ≥75 years remained static at 14% to 15% per year ( P =0.84). Projections of AF prevalence demonstrated a constant yearly rise, increasing from 700 000 patients in 2010 to between 1.3 and 1.8 million patients with AF in the United Kingdom by 2060. Conclusions In a large general practice population, incident AF increased and then plateaued overall, with a continued increase in patients aged ≥75 years. The large projected increase in AF prevalence associated with temporal changes in AF ‐related comorbidities suggests the need for comprehensive implementation of AF prevention and management strategies.