Independent Risk Factors for Atrial Fibrillation in a Population-Based Cohort: The Framingham Heart Study
Abstract
Objective. —To determine the independent risk factors for atrial fibrillation. Design. —Cohort study. Setting. —The Framingham Heart Study. Subjects. —A total of 2090 men and 2641 women members of the original cohort, free of a history of atrial fibrillation, between the ages of 55 and 94 years. Main Outcome Measures. —Sex-specific multiple logistic regression models to identify independent risk factors for atrial fibrillation, including age, smoking, diabetes, electrocardiographic left ventricular hypertrophy, hypertension, myocardial infarction, congestive heart failure, and valve disease. Results. —During up to 38 years of follow-up, 264 men and 298 women developed atrial fibrillation. After adjusting for age and other risk factors for atrial fibrillation, men had a 1.5 times greater risk of developing atrial fibrillation than women. In the full multivariable model, the odds ratio (OR) of atrial fibrillation for each decade of advancing age was 2.1 for men and 2.2 for women (P<.0001). In addition, after multivariable adjustment, diabetes (OR, 1.4 for men and 1.6 for women), hypertension (OR, 1.5 for men and 1.4 for women), congestive heart failure (OR, 4.5 for men and 5.9 for women), and valve disease (OR, 1.8 for men and 3.4 for women) were significantly associated with risk for atrial fibrillation in both sexes. Myocardial infarction (OR, 1.4) was significantly associated with the development of atrial fibrillation in men. Women were significantly more likely than men to have valvular heart disease as a risk factor for atrial fibrillation. The multivariable models were largely unchanged after eliminating subjects with valvular heart disease. Conclusion. —In addition to intrinsic cardiac causes such as valve disease and congestive heart failure, risk factors for cardiovascular disease also predispose to atrial fibrillation. Modification of risk factors for cardiovascular disease may have the added benefit of diminishing the incidence of atrial fibrillation. (JAMA. 1994;271:840-844)
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Framingham data emphasized the underappreciated contribution of obesity to atrial fibrillation risk.
“Data from Framingham also emphasized the underappreciated contribution of obesity to atrial fibrillation risk.81”
From The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective (2014) · cites this paper as [81]
Elevated body mass index, hypertension, diabetes mellitus, coronary heart disease, valvular heart disease, and heart failure are major risk factors for AF, but their prevalence varies between women and men.
“Elevated body mass index, hypertension, diabetes mellitus, coronary heart disease, valvular heart disease, and heart failure (HF) constitute major risk factors for AF, but the prevalence of these risk factors vary between women and men.3–5”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [4]
Advancing age is the most important risk factor for AF, leading to about a doubling in AF incidence with every 10-year increase in age.
“Advancing age is the most important risk factor, leading to about a doubling in AF incidence with every 10-year increase in age.4”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [4]
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Prevention of Atrial Fibrillation
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- Authors
- Benjamin, E. J.
- Corresponding author
- Benjamin, Emelia J.
- ORCID
- Benjamin, Emelia J.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 1994-03-16
- Volume
- 271
- Issue
- 11
- Pages
- 840
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W4294236164
- Cited by
- 2,613
- References
- 0
- Citations by year
- 2026: 62 · 2025: 84 · 2024: 108 · 2023: 126 · 2022: 123 · 2021: 160 · 2020: 155 · 2019: 142 · 2018: 144 · 2017: 134 · 2016: 163 · 2015: 149 · 2014: 139 · 2013: 145 · 2012: 121
- FWCI
- 5.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (N01-HC-38038)
- National Institute of Neurological Disorders and Stroke (2-R01-NS-17950-11)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- atrial fibrillation, risk factors, sex differences, age, diabetes mellitus, hypertension, congestive heart failure, valvular heart disease, myocardial infarction, left ventricular hypertrophy, cardiovascular disease, Framingham Heart Study
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