Abstract P112: Thirty-year Trends in the Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Kunali P Ghelani ◽  
Lin Yee Y Chen ◽  
Faye L Norby ◽  
Elsayed Z SOLIMAN ◽  
Silvia Koton ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
African American ◽  
African Americans ◽  
Incidence Rates ◽  
Atherosclerosis Risk In Communities ◽  
Time Period ◽  
The Us ◽  
Atherosclerosis Risk ◽  
Changes Over Time ◽  
Over Time

Objective: To evaluate the 30-year trends in the incidence of atrial fibrillation (AF) in the Atherosclerosis Risk in Communities (ARIC) cohort and identify race and sex differences in these trends. Background: Long-term data to study recent trends in the incidence of AF, overall and across sex and race groups, are scarce. Methods: We included 15,343 men and women aged 45 to 65 in 1987-89 without AF from 4 US communities in the ARIC cohort. Incident AF was identified based on study electrocardiograms, hospital discharge codes, and death certificates through 2017. We calculated age and time-period specific incidence rates (IR) of AF. We used Poisson regression to calculate IR ratios of AF over time adjusting for age, sex and race. Results: A total of 3,241 AF cases were identified during a mean (SD) follow up of 22 (8.4) years (599 in African Americans, 2642 in whites, 1582 in women, 1659 in men). Overall, the IR of AF in the ARIC cohort was 9.6 per 1000 person-years (6.9 in African American, 10.5 in whites, 8.1 in women, and 11.6 in men). Age-specific IR by time-period did not show significant changes over time (Figure). In a model adjusted for sex, race, and age group, the rate of AF did not change over time from 1987-1991 to 2012-2017 (IR ratio=1.10, 95% CI = 0.89-1.36 comparing 2012-2017 to 1987-1991). Similarly, no evidence of changes over time in AF rates were identified in men or women, whites or African Americans separately. Conclusions: Even though the incident rates of AF increase as age increases, our analysis provided evidence suggesting that the overall rates of AF have not changed over time in a multicenter cohort of African American and white individuals in the US from 1987 to 2017.

Abstract P023: Lifetime Risk of Atrial Fibrillation by Race and Socioeconomic Status: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Liping Mou ◽  
Faye Norby ◽  
Lin Chen ◽  
Wesley O'Neal ◽  
Tene Lewis ◽  
...  
Keyword(s):  
High School ◽  
Atrial Fibrillation ◽  
Socioeconomic Status ◽  
African American ◽  
African Americans ◽  
Cumulative Incidence ◽  
Lifetime Risk ◽  
School Graduate ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk

Background: The lifetime risk of atrial fibrillation (AF) has been previously reported in whites, but not in African Americans. Moreover, we lack current estimates of lifetime risk of AF that take into account recent trends in the incidence of this arrhythmia. Lifetime risk of AF by socioeconomic status has not been investigated before. Methods: We studied 15,343 whites and African Americans in the Atherosclerosis Risk in Communities study who were followed for an average of 21 years (maximum 27 years). Total family income was categorized as <$25,000, $25,000-$49,999, and ≥$50,000, and education as < high school graduate, high school graduate, and at least some college. Incident AF was ascertained from study electrocardiograms, hospital discharge records, and death certificates. Lifetime risk of AF was estimated by a modified Kaplan-Meier method that accounted for the competing risk of death. Results: We identified 2760 AF cases during follow-up. Lifetime risk of AF was 36% (95% CI: 32-38%) in white men, 30% (26-32%) in white women, 21% (13-24%) in African American men, and 22% (16-25%) in African American women (Figure). Regardless of race and sex, incidence rates of AF decreased from the lowest to highest categories of income and education. In contrast, lifetime risk of AF increased in individuals with higher income and education in most sex-race groups. Cumulative incidence of AF was lower in those with higher income and education compared to their low socioeconomic status counterparts through earlier life, but was reversed after age 80. Conclusion: Lifetime risk of AF in a contemporary cohort in the United States was approximately 1 in 3 among whites and 1 in 5 among African Americans. Socioeconomic status was inversely associated with cumulative incidence of AF before the last decades of life.

Abstract MP77: Projected Impact of Shifting Population Distributions of Blood Pressure on Rates of Coronary Heart Disease, Heart Failure and Stroke: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Shakia T Hardy ◽  
Laura R Loehr ◽  
Kenneth R Butler ◽  
Patricia P Chang ◽  
Aaron R Folsom ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
African American ◽  
Heart Disease ◽  
Population Distribution ◽  
The United States ◽  
Incidence Rates ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk

Introduction: Rates of cerebrovascular disease, heart failure (HF), and coronary heart disease (CHD), increase progressively as blood pressure rises. Several authors have estimated the theoretical effects of shifting the population distribution of blood pressure; however few studies have examined the degree to which modest decrements in blood pressure affect HF incidence, or included a racially diverse population. Methods: Incident HF was identified by a first hospitalization with discharge diagnosis code of 428.X. Incident hospitalized (definite or probable) CHD and stroke were classified according to protocol. We used multivariable regression to estimate incidence rate differences (IRD) for HF, CHD, and stroke that could be associated with a two mm Hg reduction in systolic blood pressure (SBP) in 15,744 participants from the Atherosclerosis Risk in Communities Study. Results: Over a mean of 18.3 years of follow up, age-adjusted incidence rates for HF, CHD, and stroke were higher among African American than Caucasians (Table 1). After adjusting for antihypertensive use, gender, and age, a two mm Hg decrement in SBP across the total population was associated with an estimated 24/100,000 person-years (PY) and 39/100,000 PY fewer incident HF events in Caucasians and African Americans, respectively. The projected disease reductions were of smaller absolute magnitude for incident CHD and incident stroke. Extrapolation to the African American and Caucasian U.S. populations age greater than 45 years suggests that a two mmHg decrement in SBP could result in approximately 22,000 fewer incident HF events, 15,000 fewer incident CHD events, and 5,000 fewer incident stroke events annually. Conclusion: Our results suggest that modest shifts in SBP, consistent with what could theoretically be achieved through population level lifestyle interventions, could substantially decrease the incidence of HF, stroke, and CHD in the United States, especially among African American populations.

scholarly journals Metabolomics and Incidence of Atrial Fibrillation in African Americans: The Atherosclerosis Risk in Communities (ARIC) Study

PLoS ONE ◽  
2015 ◽  
Vol 10 (11) ◽  
pp. e0142610 ◽  
Author(s):  
Alvaro Alonso ◽  
Bing Yu ◽  
Waqas T. Qureshi ◽  
Morgan E. Grams ◽  
Elizabeth Selvin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
African Americans ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

scholarly journals Marital Status, Hypertension, Coronary Heart Disease, Diabetes, and Death Among African American Women and Men: Incidence and Prevalence in the Atherosclerosis Risk in Communities (ARIC) Study Participants

2010 ◽  
Vol 31 (9) ◽  
pp. 1211-1229 ◽  
Author(s):  
Hilary M. Schwandt ◽  
Josef Coresh ◽  
Michelle J. Hindin
Keyword(s):  
Coronary Heart Disease ◽  
African American ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
African Americans ◽  
Marital Status ◽  
The United States ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Atherosclerosis Risk

Heart disease is the leading cause of death in the United States, and African Americans disproportionately experience more cardiovascular disease, including coronary heart disease (CHD), hypertension, and diabetes. The literature documents a complex relationship between marital status and health, which varies by gender. We prospectively examine the relationship between African American men’s and women’s marital status and their risk of developing cardiovascular diseases and dying using the Atherosclerosis Risk in Communities (ARIC) data. After multivariable adjustment for individual characteristics and health status, we found that marital status was not associated with hypertension or new cases of CHD, but remaining single throughout the study period was associated with an increased risk of developing diabetes for women and an increased likelihood of death for men. Culturally appropriate interventions for African Americans are needed to decrease racial disparities in cardiovascular diseases and mortality.

scholarly journals Incidence of atrial fibrillation in whites and African-Americans: The Atherosclerosis Risk in Communities (ARIC) study

2009 ◽  
Vol 158 (1) ◽  
pp. 111-117 ◽  
Author(s):  
Alvaro Alonso ◽  
Sunil K. Agarwal ◽  
Elsayed Z. Soliman ◽  
Marietta Ambrose ◽  
Alanna M. Chamberlain ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
African Americans ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Abstract 033: Epigenetic Clocks And Incident Heart Failure: The Atherosclerosis Risk In Communities (aric)

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Steven Nguyen ◽  
Carin A Northuis ◽  
Weihua Guan ◽  
Jan Bressler ◽  
Megan Grove ◽  
...  
Keyword(s):  
Heart Failure ◽  
African American ◽  
African Americans ◽  
Risk Prediction ◽  
European American ◽  
Cvd Risk ◽  
Atherosclerosis Risk In Communities ◽  
European Americans ◽  
Atherosclerosis Risk

Background: DNA methylation (DNAm)-based measures of aging, termed epigenetic clocks (EC), are associated with aging-related outcomes including cardiovascular disease (CVD) and all-cause mortality. Associations of ECs with heart failure (HF) are unclear. We tested whether ECs were positively associated with risk of incident HF in the Atherosclerosis Risk in Communities (ARIC) study and evaluated whether adding ECs to Pooled Cohort Equation (PCE) variables improved risk prediction. Methods: We measured DNAm in peripheral blood leukocytes in 2,263 African American (mean age=56.3 years) and 925 European American (mean age=59.5 years) participants using the Illumina HM450K and calculated 7 ECs: Horvath, Hannum, extrinsic (EEAA) and intrinsic (IEAA) epigenetic age acceleration, Hannum, PhenoAge, and GrimAge. HF was ascertained by ICD- 9 code 428 and adjudication by an expert panel. We carried out race stratified proportional hazards regression to test associations ECs with incident HF, adjusting for PCE variables: age, sex, smoking, total cholesterol, HDL, systolic blood pressure (SBP), antihypertensive medication use, and diabetes. We calculated area under the curve (AUC) and integrated discrimination index (IDI) to evaluate improvement in risk prediction when adding the ECs to PCE variables. Results: The number of incident HF events and mean follow-up time in African Americans and European Americans were 640 (189 in the first 10 years) and 19.3 years, and 191 and 21.7 years, respectively. All 7 ECs were positively associated with HF in both African Americans and European Americans. In African Americans with follow-up restricted to the first 10 years, the HR for a one SD increment in GrimAge (5.64 years) was 1.57 (95% CI=1.31, 1.88), comparable to that for a one-SD (5.82 years) increment in age (HR=1.58, 95% CI=1.36, 1.83) and greater than that for a one-SD (20.2mmHg) increment in SBP (HR=1.33, 95% CI=1.18, 1.51). In European Americans across the entire follow-up period, the HR for a one-SD increment in GrimAge (6.13 years) was 1.22 (95% CI=1.06, 1.41), smaller than that for a one-SD (5.50 years) increment in age (HR=1.93, 95% CI=1.63, 2.29) and larger than that for a one-SD (17.9 mmHG) increment in SBP (HR=1.13, 95% CI=0.98, 1.30). In African Americans with follow-up restricted to the first 10 years, adding GrimAge to PCE variables increased AUC by 0.019 (95% CI=0.003, 0.035) and the IDI was 0.010 (95% CI=0.002, 0.019). In European Americans, adding GrimAge did not change AUC appreciably (0.004, 95% CI=-0.006, 0.014) and the IDI was 0.002 (95% CI=0.000, 0.005). Conclusion: ECs are positively associated with HF in African American and European American participants independent of traditional CVD risk factors. GrimAge modestly improved heart failure risk prediction in African Americans. HF-specific DNAm-based measures should be developed and evaluated for improvement in risk prediction.

Abstract P111: Serum and Dietary Magnesium and the Incidence of Atrial Fibrillation in Whites and African Americans: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jeffrey R Misialek ◽  
Faye L Lopez ◽  
Rachel R Huxley ◽  
James M Peacock ◽  
Lin Y Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Cardiovascular Risk ◽  
African Americans ◽  
Cardiovascular Risk Factors ◽  
Serum Magnesium ◽  
The United States ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Background: Low serum magnesium (Mg) has been associated with a higher cardiovascular risk and other cardiovascular diseases (CVD) including ventricular arrhythmias. However, the association between serum or dietary Mg and atrial fibrillation (AF) has not been investigated to date. Methods: We studied 14,290 men and women (75% white, 53% women, mean age 54) free of AF at baseline participating in the Atherosclerosis Risk in Communities (ARIC) study, a community-based cohort in the United States. Serum Mg was assessed at baseline (1987-89) and a second visit (1990-92) while dietary Mg was assessed at baseline and a third visit (1993-95). The mean value of two Mg measurements were used for individuals who attended both visits while the baseline Mg measurement was used for individuals who did not attend another visit or were censored. Incident AF cases through 2008 were ascertained from electrocardiograms, hospital discharge codes, and death certificates. Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals for AF associated with serum and dietary Mg quintiles. Models were initially adjusted for age, sex, race, and ARIC field center, and additional models further adjusted for other cardiovascular risk factors and prevalent CVD. Dietary Mg analyses included correlated dietary covariates in all models. Interaction by race and sex was tested for serum and dietary Mg. Results: Over a median follow-up time of 19.7 years, 1,613 incident AF cases were identified. Higher serum Mg was associated with lower AF risk even after adjustment for cardiovascular risk factors and other CVD (table), with no evidence of significant interactions between serum Mg and sex or race. No significant association was identified between dietary Mg and AF. Conclusion: High serum Mg was associated with a lower AF risk, and this association was not different between whites and African Americans. Dietary Mg was not associated with AF risk. Funding(This research has received full or partial funding support from the American Heart Association, National Center)

Abstract P214: Twenty-five Years Trends in Stroke Incidence in the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Silvia Koton ◽  
Andrea L Schneider ◽  
Wayne D Rosamond ◽  
Rebecca F Gottesman ◽  
Josef Coresh
Keyword(s):  
African Americans ◽  
Incidence Rate ◽  
Poisson Regression ◽  
Incidence Rates ◽  
Age Group ◽  
Calendar Time ◽  
Stroke Incidence ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Rate Ratios

Introduction: Prior studies have shown a decrease in stroke mortality rates, but data on validated stroke incidence and trends by race are more limited. We aimed to study trends in stroke incidence by age and race in the Atherosclerosis Risk in Communities (ARIC) population from 1987 to 2010. Hypothesis: We assessed the hypothesis that total stroke incidence rates are decreasing over calendar time in all age groups, and in whites and African-Americans. Methods: ARIC participants were recruited in 1987-1989 and followed until 2010. A computer algorithm and physician reviewers identified and adjudicated definite and probable stroke as ischemic, intracerebral hemorrhage and subarachnoid hemorrhage (total stroke). A person-years (PY) approach using 5-year periods for age and calendar time was used for studying rates of total stroke incidence and trends. Poisson regression modeled calendar time in 5-year periods and linearly per decade, adjusted for 5-year age group. Results: From 1987 to 2010, 994 strokes occurred over 274,837 PY in 14,145 participants free of stroke at baseline. Total stroke incidence rates by age and calendar time increased with age and generally decreased with time ( Table ). Poisson regression adjusted for age group showed incidence rate ratios of 2.28 (95% CI 2.01-2.59) for African-Americans, compared to whites. Using the 1992-1996 as reference period, incidence rate ratios were 0.90 (0.70-1.16) for 1987-1991, 0.84 (0.69-1.02) for 1997-2001, 0.69 (0.56-0.85) for 2002-2006, and 0.59 (0.46-0.75) for 2007-2010. Analysis stratified by race shows an incidence rate ratio decrease per decade of -27% (-13% to - 39%) in whites and -22% (-5% to -34%) in African-Americans. Conclusions: Validated total stroke incidence rates decreased over calendar time from 1992 to 2010 in the ARIC cohort in both whites and African-Americans, after taking the aging of the cohort into account. Cohorts like ARIC only represent a limited age range but provide an ability to use validated events in updating stroke incidence trends.

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