Risk factors for silent and symptomatic atrial fibrillation in an elderly population screening programme:a report from the noninvasive monitoring for early detection of atrial fibrillation (NOMED-AF)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Mitrega ◽  
B Sredniawa ◽  
J Stokwiszewski ◽  
A Sokal ◽  
J Boidol ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
General Population ◽  
Population Sample ◽  
Population Based ◽  
Public Institution ◽  
Elderly Subjects ◽  
Funding Source ◽  
Cross Sectional ◽  
Independent Risk Factors

Abstract Background It is important to determine the risk factors that predispose elderly subjects from the general population for symptomatic atrial fibrillation and atrial flutter (AF/AFl), but population-based data for silent AF (SAF) are limited. Aim To study risk factors for symptomatic AF and SAF in a general population screen for subjects age ≥65 where continuous monitoring was performed up to 30 days with a vest-based monitor. Methods The NOMED-AF study was a cross-sectional study based on a representative population sample (n=3014; mean age 77.5±7.9 years; F=1479). In 680 subjects AF/AFl (including 279 with SAF) was diagnosed. Independent risk factors for AF/AFl and SAF were determine on weighted data using multiple logistic regression. Results The independent risk factors for AF/AFl and SAF are summarised in the Table. There are nine independent risk factors for AF/AFl and eight for SAF. Revascularization and obesity were independently associated with patients with (symptomatic) AF/AFl, and CKD was associated with SAF. Other risk factors are common for AF/AFl and SAF. Conclusions AF/AFl and SAF have slightly different associated clinical risk factors in this representative population sample aged ≥65 years. This may facilitated targeted screening programmes for high risk subgroups, particularly for SAF. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): The research has received funding from the National Centre for Research and Development under grant agreement (STRATEGMED2/269343/18/NCBR/2016)

scholarly journals Prevalence of atrial fibrillation and cardiovascular risk factors in a 63–65 years old general population cohort: the Akershus Cardiac Examination (ACE) 1950 Study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021704 ◽  
Author(s):  
Trygve Berge ◽  
Magnus Nakrem Lyngbakken ◽  
Håkon Ihle-Hansen ◽  
Jon Brynildsen ◽  
Mohammad Osman Pervez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cardiovascular Risk ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Population Based ◽  
Degree Relative ◽  
Cross Sectional ◽  
General Population Cohort ◽  
Prospective Longitudinal

ObjectivesTo investigate the sex-specific prevalence of atrial fibrillation (AF), including subclinical AF found by screening in a general population aged 63–65 years. The prevalence of cardiovascular risk factors and their association with AF will also be investigated.DesignCross-sectional analysis of an observational, prospective, longitudinal, population-based cohort study.SettingGeneral population in Akershus county, Norway.ParticipantsWomen and men born in 1950. We included 3706 of 5827 eligible individuals (63.6%); 48.8% were women.MethodsAll participants underwent extensive cardiovascular examinations, including 12-lead ECG. History of AF and other cardiovascular diseases were self-reported. Subsequent validation of all reported or detected AF diagnoses was performed.ResultsMean age was 63.9±0.7 years. Prevalence of ECG-verified AF was 4.5% (women 2.4%, men 6.4%; p<0.001), including screen-detected AF in 0.3% (women 0.1%, men 0.6%; p<0.01). Hypertension was found in 62.0% (women 57.8%, men 66.0%; p<0.001). Overweight or obesity was found in 67.6% (women 59.8%, men 74.9%; p<0.001). By multivariate logistic regression, risk factors associated with AF were height (OR 1.67 per 10 cm; 95% CI 1.26 to 2.22; p<0.001), weight (OR 1.15 per 10 kg; 95% CI 1.01 to 1.30; p=0.03), hypertension (OR 2.49; 95% CI 1.61 to 3.86; p<0.001), heart failure (OR 3.51; 95% CI 1.71 to 7.24; p=0.001), reduced estimated glomerular filtration rate (OR 2.56; 95% CI 1.42 to 4.60; p<0.01) and at least one first-degree relative with AF (OR 2.32; 95% CI 1.63 to 3.31; p<0.001), whereas male sex was not significantly associated (OR 1.00; 95% CI 0.59 to 1.68; p=0.99).ConclusionIn this cohort from the general population aged 63–65 years, we found a higher prevalence of known AF than previously reported below the age of 65 years. The additional yield of single time point screening for AF was low. Body size and comorbidity may explain most of the sex difference in AF prevalence at this age.Trial registration numberNCT01555411; Results.

scholarly journals Predicting silent atrial fibrillation in the elderly – NOMED-AF study

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
K Mitrega ◽  
G Y H Lip ◽  
B Sredniawa ◽  
A Sokal ◽  
W Streb ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Atrial Fibrillation ◽  
General Population ◽  
Risk Stratification ◽  
Population Sample ◽  
Male Gender ◽  
Public Institution ◽  
Dash Score ◽  
Clinical Risk

Abstract Background Asymptomatic (“silent”) atrial fibrillation is common and associated with poor outcomes. It is important to determine the risk factors that predispose elderly individuals from the general population to atrial fibrillation (AF). However, population-based data for silent AF (SAF) are limited. Design First, to study the risk factors for symptomatic AF and SAF in an elderly (≥65 years) general population. Second, to develop a risk stratification model for predicting SAF. Methods Continuous ECG monitoring was performed for up to 30 days using a vest-based system in a cohort from NOMED-AF, a cross-sectional study based on a nationwide population sample. The independent risk factors for AF and SAF were determined using multiple logistic regression. ROC analysis was applied to validate developed risk stratification score. Results From the total cohort of 3014 subjects, AF was diagnosed in 680 individuals (mean age, 77.5±7.9; 50.1% men) with AF, and of these, 279 (41%) had SAF. Independent associations with an increased risk of AF were age, male gender, coronary heart disease, thyroid diseases, prior ischemic stroke or transient ischemic attack (ICS/TIA), diabetes, heart failure, chronic kidney disease (CKD), obesity (BMI&gt;30) and NT-proBNP &gt;125 ng/ml. Prior revascularization was negatively associated with risk of AF. The main risk factors for SAF were age, male gender, prior ICS/TIA, diabetes, heart failure, CKD and NT-proBNP &gt;125 ng/ml. We developed a simple clinical risk scale (MR-DASH score) which had good prediction in the derivation cohort (AUC 0.726) and the validation cohort (AUC 0.730). Conclusions SAF is associated with various clinical risk factors in a population sample of individuals ≥65 years. Stratifying individuals from the general population according to their risk for SAF may be possible using the MR-DASH score, facilitating targeted screening programs of individuals with high risk of SAF FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): National Centre for Research and Development

scholarly journals The prevalence and risk factors of high-altitude pulmonary hypertension among native Tibetans in Sichuan Province, China

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Q.L Gou ◽  
R.F Shi ◽  
X Zhang ◽  
Q.T Meng ◽  
X.R Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Pulmonary Hypertension ◽  
High Altitude ◽  
Multivariate Logistic Regression Analysis ◽  
Sichuan Province ◽  
Public Institution ◽  
P Value ◽  
Funding Source ◽  
Cross Sectional

Abstract Background High-altitude pulmonary hypertension (HAPH) remains a concern due to its high mortality, however, studies evaluating its prevalence and risk factors are lacking. Objective To determine the prevalence of HAPH and its correlated factors among the highlanders living at 3200 metres above sea level in Ganzi Tibetan Automous Prefecture, Sichuan Province, China. Methods This was a single-center cross-sectional study involved 1129 subjects (mean age 46.6±14 years, 39% men). Native Tibetans with HAPH were defined as mean pulmonary artery pressure &gt;30mmHg achieved from transthoracic echocardiography. Results The crude prevalence of HAPH was 6.2%, and was more prevalent in men compared to women (8.6% vs 4.6%, P=0.005). The elder was more likely to develop HAPH (OR: 5.308, 95% CI: 2.562–10.993). Highlanders with HAPH had more severe metabolic abnormalities (including elevated blood pressure, blood glucose, blood lipids, BMI, etc. P value&lt;0.05) and significantly increased hemoglobin level (P=0.001). On multivariate logistic regression analysis, independent risk factors for HAPH were metabolic syndrome (OR: 3.128, 95% CI: 1.110–8.818), age (&gt;60 years vs &lt;40 years) (OR: 2.924, 95% CI: 1.282–6.669), and decreased SpO2 (OR: 1.072 per 1-unit decrease; 95% CI: 1.010–1.136). Conclusion It could be concluded that HAPH was prevalent among 6.2% native Tibetans in Sichuan Province, China. Increasing age, metabolic syndrome and decreased SpO2 were independent predisposing factors for HAPH Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): This study was funded by one Science and Technology Pillar Programs in Sichuan Province (Grant no. 2017SZ0008).

Sex-specific temporal trends in the incidence of atrial fibrillation in a large Norwegian population-based study 1986–2014

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Sharashova ◽  
T Wilsgaard ◽  
J Ball ◽  
E Gerdts ◽  
A Rosengren ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
General Population ◽  
Linear Time ◽  
Population Aging ◽  
Temporal Trends ◽  
Population Based ◽  
Incidence Rates ◽  
University Hospital ◽  
Funding Source

Abstract Background Due to population aging, increasing prevalence of obesity and enhanced detection, the prevalence of atrial fibrillation (AF) worldwide is increasing steadily. Considerable sex differences in the epidemiology of AF such as lower prevalence and later onset in women compared to men have been reported. However, little is known about sex-specific temporal trends in AF incidence within the general population. Purpose To explore sex-specific age-adjusted secular trends in the incidence of AF in a general population from Norway between 1986 and 2014. Methods A total of 16,865 men and 15,413 women aged 20 years or older and without AF were enrolled in a longitudinal population study between 1986 and 2008 and followed up for incident AF to the end of 2014. Follow-up was from the date of attendance to the date of AF, emigration or death, whichever came first. All AF cases were validated by an independent endpoint committee using hospital and death records. AF incidence rates were calculated for each calendar year by dividing the number of AF cases per year by the corresponding person-time at risk. To allow for non-linear time trends, calendar year was fitted using fractional polynomials. Poisson regression was used to estimate calendar year-specific AF incidence rates adjusted for age. All analyses were stratified by sex. Results A total of 911 AF events in women and 1,139 AF events in men occurred over 324,090 person-years and 294,531 person-years of follow-up, respectively. During the study period AF incidence rates in men were at least double that in women (Figure). Age-adjusted AF incidence rates in women increased from 1986, peaked at 0.87 per 1000 person-years in 1998 and then decreased slightly towards 2014. In men AF incidence rates increased up to 2.18 per 1000 person-years in 2005 and then steeply decreased. Conclusion(s) AF incidence rates decreased in both women and men towards the end of the study period. The decrease was more profound in men compared to that in women. One possible explanation is more pronounced reduction in incidence and better treatment of myocardial infarction in men compared to women given that the aetiology of AF in men is mainly ischemic heart disease-related. However, further epidemiological analyses should be undertaken to identify explanatory factors. Funding Acknowledgement Type of funding source: Public hospital(s). Main funding source(s): University Hospital of North Norway, Northern Norway Regional Health Authority

scholarly journals Distribution and risk profile of atrial fibrillation patterns among women and men from the general population

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
M J Tilly ◽  
Z Lu ◽  
S Geurts ◽  
M A Ikram ◽  
M P M De Maat ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Risk Factor ◽  
Cardiovascular Risk ◽  
General Population ◽  
Population Based ◽  
Mixed Effect ◽  
Duration Of Symptoms ◽  
Men And Women

Abstract Background In a clinical setting, atrial fibrillation (AF) subgroups are defined, including paroxysmal, persistent, and permanent AF. These subgroups differ in terms of clinical characteristics, management strategy, and long-term outcomes. Application of clinical classifications in population-based settings is challenging as they are based on the duration of symptoms, recurrence, and treatment. Purpose We aim to develop an objective and standardized classification for AF patterns in the general population and examine the associated cardiovascular risk profiles and outcomes for the identified AF patterns. Methods Participants with only one reported AF episode were categorized as single-documented AF, if at least two separate AF episodes were reported as multiple-documented AF and as longstanding persistent AF if at least two consecutive ECG's at the research center showed AF, not followed by an ECG showing sinus rhythm. We fitted mixed effect models with age as time scale to characterize sex-specific cardiovascular risk factor trajectories preceding each AF pattern. We further used Cox proportional hazard modelling to describe the risk of coronary heart disease (CHD), heart failure (HF), stroke, and all-cause mortality following AF. Results We included 14,620 men and women aged ≥45 years. 1137 participants were categorized as single-documented AF, 208 as multiple-documented AF, and 57 as longstanding persistent AF. We identified significant differences in the preceding trajectories of weight, body mass index, systolic blood pressure, diastolic blood pressure, waist circumference, hip circumference, and waist-hip ratio with various AF patterns. In general, both men and women with persistent-elevated levels of these risk factors were prone to longstanding persistent AF. AF was associated with a large risk for subsequent CHD, HF, stroke, and mortality in the general population. Among the different AF patterns, single-documented AF conferred the largest risk of CHD [hazard ratio, 95% confidence interval: 1.92 (1.19–3.03)] and mortality [1.70 (1.41–2.07)] as compared to multiple-documented AF, and as compared to longstanding persistent AF [1.45 (0.72–2.90) and 3.66 (2.25–5.95), respectively]. Conclusion We developed a classification for AF patterns within a general population. We identified differences in risk factor trajectories preceding each AF pattern, which implies differences in pathophysiological mechanisms underlying AF. Participants with single-documented AF showed worse prognosis than those with multiple AF episodes. This might be due to the subgroup definition, since participants should live for a longer period of time to be categorized in the multiple-documented AF and longstanding persistent AF groups. This can also imply that participants suffering from multiple AF episodes are more frequently monitored, and treated for other risk factors. However, this could also suggest that singular AF episodes are not as innocent as commonly thought. FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): - Erasmus MC Mrace grant. - Netherlands Organization for the Health Research and Development (ZonMw) Figure 1 Figure 2. Progosis of various AF patterns

Symptoms of depression and anxiety during adult life: evidence for a decline in prevalence with age

1998 ◽  
Vol 28 (6) ◽  
pp. 1321-1328 ◽  
Author(s):  
A. S. HENDERSON ◽  
A. F. JORM ◽  
A. E. KORTEN ◽  
P. JACOMB ◽  
H. CHRISTENSEN ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Population Sample ◽  
Adult Life ◽  
Depression And Anxiety ◽  
Adverse Life Events ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
Increased Risk ◽  
Striking Change

Background. To test the hypothesis that the prevalence, in the general population, of symptoms of depression and anxiety declines with age.Methods. A general population sample of 2725 persons aged 18 to 79 years was administered two inventories for current symptoms of depression and anxiety, together with measures of neuroticism and of exposures that may confer increased risk of such symptoms.Results. Symptoms of depression showed a decline with age in both men and women. For anxiety, the decline was statistically significant for women but not consistently so for men. For the risk factors examined, there was a decline with age in the neuroticism score, the frequency of adverse life events, being seriously short of money and having had parents who separated or divorced. Further analysis showed that the association between age and a declining symptom score cannot be entirely attributed to these risk factors, with the single exception of neuroticism. The latter is itself likely to be contaminated by current symptoms.Conclusion. Unless these findings are due to bias in the sample of those who agreed to participate, they add to the evidence that symptoms of depression and to a lesser extent of anxiety decline in prevalence with age. Some risk factors also decline with age. It now has to be determined if these cross-sectional observations are also to be found in longitudinal data; and what process may underlie this striking change in mental health during adulthood.

scholarly journals Prevalence of and independent risk factors for metabolic syndrome in adults: a population-based, cross-sectional, epidemiological survey in Jiangxi province, China

2019 ◽  
Author(s):  
liting wu ◽  
YunFeng SHEN ◽  
Lei HU ◽  
MeiYing Zhang ◽  
XiaoYang LAI
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Population Based ◽  
Education Level ◽  
Jiangxi Province ◽  
Prevalence Rates ◽  
Cross Sectional ◽  
Low Education ◽  
Independent Risk Factors ◽  
Menopausal State

Abstract Background Metabolic syndrome (MS) has abruptly increased in China in the past two decades, gradually representing an important public health threat over the years. Here, we firstly reported the prevalence of and independent risk factors for metabolic syndrome in Jiangxi province, China. Methods A population-based cross-sectional survey was performed in Jiangxi province, China, from April to August 2015. MS was diagnosed by International Diabetes Federation (IDF) and Chinese Diabetes Society (CDS) criteria, respectively. Independent risk factors for MS were investigated by multivariate logistic regression. Results A total of 2665 residents aged over 18 years were enrolled, and 2580 effectively participated. According to IDF and CDS criteria, age-standardized prevalence rates of MS were 21.1% and 15.2% in all participants, respectively; prevalence rates were 19.6% and 17.1% in men, and 22.7% or 13.0% in women, based on these respective criteria. Rural participants had a significantly higher prevalence than urban individuals, so did rural females. Prevalence in males did not differ between rural and urban participants. Furthermore, both low education level and menopausal state were independent risk factors for MS in adults. Conclusions MS is highly prevalent in adults in Jiangxi province, China. Low education level and menopausal state are independent risk factors for MS.

Predictors of Outcome for Orofacial Pain in the General Population: a Four-year Follow-up Study

2004 ◽  
Vol 83 (9) ◽  
pp. 712-717 ◽  
Author(s):  
T.V. Macfarlane ◽  
A.S. Blinkhorn ◽  
R.M. Davies ◽  
J. Kincey ◽  
H.V. Worthington
Keyword(s):  
General Population ◽  
Orofacial Pain ◽  
Population Sample ◽  
Participation Rate ◽  
Population Based ◽  
Predictors Of Outcome ◽  
Cross Sectional ◽  
The United Kingdom ◽  
Population Based Survey

Orofacial pain is often persistent, but it is not clear why it lasts in some patients but not in others. We aimed to describe the natural course of orofacial pain in a general population sample over a four-year period and to identify factors that would predict the persistence of pain. A cross-sectional population-based survey was conducted in the United Kingdom, involving 2504 participants (participation rate 74%), of whom 646 (26%) reported orofacial pain. Overall, 424 (79% adjusted participation rate) of these individuals participated at the four-year follow-up, of whom 229 (54%) reported orofacial pain and 195 (46%) did not report such pain. Persistent orofacial pain was associated with females, older age, psychological distress, widespread body pain, and taking medication for orofacial pain at baseline. These findings may have implications for the identification and treatment of patients with orofacial pain.

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