Prevalence, Incidence, and Lifetime Risk of Atrial Fibrillation in China
Abstract
Background Much of the epidemiology of atrial fibrillation (AF) is based on data from Western populations. Despite the huge population of Asia, data on the clinical epidemiology of AF in Asian countries are limited. The current study aimed to investigate the prevalence and incidence of newly diagnosed (ie, incident) AF, as well as lifetime risk, in China and to determine the clinical risk factors contributing to its development.Methods Using a medical insurance database involving > 10 million individuals for the years 2001 to 2012 in the southwest of China, trends in incident AF were calculated using Kaplan-Meier analysis and Cox regression. The usefulness of the CHADS2 (congestive heart failure, hypertension, age, diabetes, stroke [doubled]) and CHA2DS2-VASc (congestive heart failure, hypertension, age ≥ 75 [doubled], diabetes, stroke [doubled], vascular disease, age 65-74, and sex category [female]) scores was tested in predicting the occurrence of incident AF.Results A total of 471,446 individuals (aged ≥ 20 years) were studied, with 1,924,975 person-years of experience. We identified 921 patients with incident AF (62% male; mean age, 62 years). The prevalence of incident AF in subjects aged ≥ 20 years was 0.2 per 100 people, with an incidence of AF of 0.05 per 100 person-years overall. Over an 11-year period, the prevalence of AF increased 20-fold, whereas AF-related stroke increased 13-fold. The lifetime risk of AF was approximately one in five among Chinese adults, and it increased with advancing age. The CHA2DS2-VASc score was superior to the CHADS2 score in predicting the risk of incident AF in our Chinese population (DeLong test, Z = 6.621, P < .001).Conclusions The AF burden, as well as the risk of AF-related stroke, has increased significantly over the past 11 years in the southwest of China. The public health burden of AF and its complications are greatest in the very elderly, with major implications for health-care systems given the global burden of this common arrhythmia.
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Part of the increased risk of AF observed in men is related to body size.
“The study findings indicated that part of the increased risk of AF observed in men was related to body size.”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [32]
After adjusting for height and other AF risk factors, male sex was no longer significantly associated with incident AF in a three-cohort study.
“However, after adjusting for height and other AF risk factors, a multivariable risk score for incident AF in a three-cohort study showed male sex was no longer significantly associated with AF.32”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [32]
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- Authors
- Guo, Y., Tian, Y., Wang, H., Si, Q., Wang, Y., & Lip, G. Y. H.
- Affiliations
- Chinese PLA General Hospital (CN)
- Second People's Hospital of Yunnan Province (CN)
- Birmingham City Hospital (GB)
- Corresponding author
- Lip, Gregory Y.H.
- Venue
- Chest
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 147
- Issue
- 1
- Pages
- 109-119
- ISSN
- 0012-3692 (ISSN-L)
- OpenAlex
- W2069391559
- Cited by
- 255
- References
- 55
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 22 · 2023: 23 · 2022: 39 · 2021: 21 · 2020: 30 · 2019: 23 · 2018: 25 · 2017: 23 · 2016: 16 · 2015: 11 · 2014: 3
- FWCI
- 12.12
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- CHEST Journal (publishedVersion)
- PubMed (publishedVersion)
- 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, incidence, lifetime risk, CHA2DS2-VASc score, CHADS2 score, risk prediction, risk factors, aging, China
- MeSH terms
- Adult, Atrial Fibrillation, China, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Retrospective Studies, Risk Factors, Incidence, Prevalence, Risk Assessment, Kaplan-Meier Estimate, Young Adult
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