The Long- and Short-Term Impact of Elevated Body Mass Index on the Risk of New Atrial Fibrillation
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Objectives The purpose of this study was to characterize the relationship between changes in body mass index (BMI) and incident atrial fibrillation (AF) in a large cohort of women.Background Obesity and AF are increasing public health problems. The importance of dynamic obesity-associated AF risk is uncertain, and mediators are not well characterized.Methods Cases of AF were confirmed by medical record review in 34,309 participants in the Women's Health Study. Baseline and updated measures of BMI were obtained from periodic questionnaires.Results During 12.9 +/- 1.9 years of follow-up, 834 AF events were confirmed. BMI was linearly associated with AF risk, with a 4.7% (95% confidence interval [CI]: 3.4 to 6.1, p < 0.0001) increase in risk with each kilogram per square meter. Adjustment for inflammatory markers minimally attenuated this risk. When updated measures of BMI were used to estimate dynamic risk, overweight (hazard ratio [HR]: 1.22; 95% CI: 1.02 to 1.45, p = 0.03), and obesity (HR: 1.65; 95% CI: 1.36 to 2.00; p < 0.0001) were associated with adjusted short-term increases in AF risk. Participants becoming obese during the first 60 months had a 41% adjusted increase in risk of the development of AF (p = 0.02) compared with those maintaining BMI <30 kg/m(2). The prevalence of overweight and obesity increased over time. The adjusted proportion of incident AF attributable to short-term elevations in BMI was substantial (18.3%).Conclusions In this population of apparently healthy women, BMI was associated with short- and long-term increases in AF risk, accounting for a large proportion of incident AF independent of traditional risk factors. A strategy of weight control may reduce the increasing incidence of AF. (Women's Health Study [WHS]: A Randomized Trial of Low-Dose Aspirin and Vitamin E in the Primary Prevention of Cardiovascular Disease and Cancer; NCT00000479).
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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 [3]
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Genetic Obesity and the Risk of Atrial Fibrillation
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Treatment of Patients With Atrial Fibrillation and Heart Failure With Reduced Ejection Fraction
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Cardiac adipose tissue and atrial fibrillation: the perils of adiposity
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Physical Activity and the Risk of Incident Atrial Fibrillation in Women
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Atrial Fibrillation and Obesity
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Self-citationLean Body Mass Is the Predominant Anthropometric Risk Factor for Atrial Fibrillation
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Obesity, Diabetes and Atrial Fibrillation; Epidemiology, Mechanisms and Interventions
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Self-citationObesity is associated with incident atrial fibrillation independent of gender: A meta‐analysis
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Balla, S. R., Cyr, D. D., Lokhnygina, Y. V., Becker, R. C., Berkowitz, S. D., BREITHARDT, G. E., Fox, K. A. A., Hacke, W., Halperin, J. L., Hankey, G. J., et al. (2017) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2017.03.028 · Cited by 88 · see citing works
- Authors
- Tedrow, U. B., Conen, D., Ridker, P. M., Cook, N. R., Koplan, B. A., Manson, J. E., Buring, J. E., & Albert, C. M.
- Affiliations
- Brigham and Women's Hospital (US)
- Corresponding author
- Tedrow, Usha B.
- ORCID
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2010-05
- Volume
- 55
- Issue
- 21
- Pages
- 2319-2327
- ISSN
- 0735-1097 (ISSN-L)
- PMC
- PMC2880879
- OpenAlex
- W1786577233
- Cited by
- 500
- References
- 35
- Citations by year
- 2026: 15 · 2025: 27 · 2024: 33 · 2023: 35 · 2022: 34 · 2021: 36 · 2020: 34 · 2019: 27 · 2018: 40 · 2017: 52 · 2016: 37 · 2015: 28 · 2014: 20 · 2013: 26 · 2012: 27
- FWCI
- 17.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Watkins and Harris Family Foundation
- National Heart, Lung and Blood Institute (HL-093613, HL-043851, HL-080467)
- National Cancer Institute (CA-047988)
- The Donald W. Reynolds Foundation
- Biosense Webster
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Disease and Adiposity
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- atrial fibrillation, body mass index, obesity, overweight, weight gain, incident atrial fibrillation risk, women, inflammatory markers, weight management, Women's Health Study
- MeSH terms
- Anti-Arrhythmia Agents, Atrial Fibrillation, Electrocardiography, Female, Follow-Up Studies, Humans, Middle Aged, Obesity, Severity of Illness Index, Time Factors, Cohort Studies, Comorbidity, Body Mass Index, Incidence, Survival Rate, Women's Health, Treatment Outcome, Catheter Ablation, Risk Assessment, Overweight
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