Prevalence of atrial fibrillation in the general population and in high-risk groups: the ECHOES study
Open accessAbstract
AIMS: To establish the prevalence of atrial fibrillation (AF) in the general population in the UK, and in those with risk factors. METHODS AND RESULTS: The prevalence of AF on electrocardiography was established in prospectively selected groups: 3960 randomly selected from the population, aged 45+; 782 with a previous diagnosis of heart failure; and 1062 with a record of myocardial infarction, hypertension, angina, or diabetes. Patients were also assessed clinically and with echocardiography. Mortality was tracked for 8 years. Atrial fibrillation was found in 78 of the random population sample (2.0%). Prevalence was 1.6% in women and 2.4% in men, rising with age from 0.2% in those aged 45-54 to 8.0% in those aged 75 and older. Half of all cases were in patients aged 75 and older. Only 23 of the 78 (29.5%) of those in AF took warfarin. Of the 782 patients, 175 (22.4%) with a diagnosis of heart failure were in AF, with normal left ventricular function in 95 (54.3%) of these. Atrial fibrillation was found in 14 of the 244 (5.7%) of those with a history of myocardial infarction, 15 of the 388 (3.9%) of those with hypertension, 15 of the 321 (4.7%) of those with angina, and 11 of the 208 (5.3%) of diabetics. Adjusting for age and sex, mortality was 1.57 times higher for those in AF. CONCLUSION: Atrial fibrillation is common in the elderly and those with clinical risk factors. Screening these groups would identify many with AF. Use of anticoagulation was low at the time of the initial assessments in the late 1990s; practice may have changed recently.
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Undiagnosed AF is common, especially in older populations and in patients with heart failure.
“Undiagnosed AF is common, especially in older populations and in patients with heart failure.130”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [130]
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- Authors
- Davis, R. C., Hobbs, F. D. R., Kenkre, J. E., Roalfe, A. K., Iles, R., Lip, G. Y. H., & Davies, M. K.
- Affiliations
- Sandwell & West Birmingham Hospitals NHS Trust (GB)
- University of Glamorgan (GB)
- University of Birmingham (GB)
- University Hospitals Birmingham NHS Foundation Trust (GB)
- Corresponding author
- Davis, R. C.
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2012-04-05
- Volume
- 14
- Issue
- 11
- Pages
- 1553-1559
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W1969934955
- Cited by
- 180
- References
- 27
- Citations by year
- 2026: 5 · 2025: 9 · 2024: 4 · 2023: 9 · 2022: 13 · 2021: 14 · 2020: 19 · 2019: 14 · 2018: 17 · 2017: 18 · 2016: 15 · 2015: 11 · 2014: 19 · 2013: 11 · 2012: 2
- FWCI
- 8.85
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Funders
- Health Services Research and Development
- National Institute for Health and Care Research (NF-SI-0611-10273)
- Health Technology Assessment Programme
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Keywords
- atrial fibrillation, prevalence, general population, heart failure, myocardial infarction, hypertension, angina pectoris, diabetes mellitus, older adults, mortality, warfarin anticoagulation, risk factors, screening
- MeSH terms
- Age Factors, Aged, Aged, 80 and over, Angina Pectoris, Anticoagulants, Atrial Fibrillation, Cross-Sectional Studies, Diabetes Mellitus, England, Female, Heart Failure, Humans, Hypertension, Male, Middle Aged, Myocardial Infarction, Prognosis, Prospective Studies, Risk Factors, Sex Factors, Time Factors, Ultrasonography, Prevalence, Multivariate Analysis, Chi-Square Distribution, Logistic Models, Proportional Hazards Models, Odds Ratio, Age Distribution, Sex Distribution, Kaplan-Meier Estimate
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