Atrial fibrillation rates rose even more than predicted
There may have been 10.55 million U.S. adults diagnosed with atrial fibrillation (AF) in 2019, exceeding predictions from previous decades, according to an analysis of all patients treated in California.
The U.S. prevalence of diagnosed atrial fibrillation (AF) was higher than previously estimated, a study found.
A previous study using data from 1996-1997 projected that there would be 3.3 million adults with AF in the United States in 2020. To assess the current prevalence, researchers merged California's statewide health care databases to create a cohort of adults age 20 years or older who received hospital-based care in the state from 2005 to 2019. After accounting for deaths, researchers used U.S. Census figures to estimate the national age-, sex-, and race-standardized prevalence of AF. Results appeared Sept. 11 in the Journal of the American College of Cardiology.
Of more than 29 million patients, more than 2 million (6.8%) had an AF diagnosis. The proportion of adults in California with a diagnosis of AF increased from 4.49% (95% CI, 4.48% to 4.50%) in 2005 to 2009 to 6.82% (95% CI, 6.81% to 6.84%) in 2015 to 2019. Rates were higher among inpatients compared with surgical and ED patients and increased over time in all settings. Men, older patients, and White and Asian patients had higher AF rates, but rates consistently increased over time across all demographic groups. Patients with a diagnosis of AF in 2015 to 2019 were younger, less likely to be female or White, and more likely to have hypertension and diabetes than patients during the periods of 2005 to 2009 and 2010 to 2014, a finding that researchers called “remarkable.”
The study authors concluded that there were at least 10.55 million people with AF in the United States at the end of 2019. This was substantially higher than the 3.33 million and the 7.5 million each projected to occur for 2020 by two studies conducted more than 20 years ago. They noted that their study data came from acute health care settings that may not reflect the general population.
“Although major progress has been made in the management of AF, resulting in a decline in adverse outcomes in the population with AF, the rising prevalence of AF reported in this study calls for more effective prevention strategies targeting lifestyle modification and pertinent comorbidities such as hypertension, diabetes, obesity, obstructive sleep apnea, heart failure, and coronary artery disease,” the authors wrote.
An editorial called the study's results a wake-up call for health care. “The rapid rise in AF prevalence is not merely a statistical anomaly, but is a reflection of deeper societal trends,” the editorial stated. “It calls us to reflect on our collective health, our priorities, and the kind of future we envision for our society. Each step we take toward better prevention, detection, and management of AF is a step toward a healthier future for all and a decreased burden on the health care system. The journey ahead is driven by urgency and hope about cultivating a community where every sinus beat counts clinically, financially, and epidemiologically!”