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Obesity Linked With Increased Risk of Atrial Fibrillation

Janice Simmons

New research using data from the Framingham Heart Study says that obesity is associated with a 50% increase in the risk of atrial fibrillation (AF), the most common disturbance of cardiac rhythm, according to a study published in the November 2004 issue of JAMA.¹

"Studies in the past have suggested that there might be an association [between AF and obesity], but the data have been a little bit conflicting on that association," writes Thomas Wang, MD, the lead author of the study and a staff cardiologist at Massachusetts General Hospital in Boston.

Although the question was not specifically examined in the study, this new research suggests that "weight loss reduces the risk of atrial fibrillation and abnormal rhythms," says Wang, who is also a research associate with the Framingham Heart Study. While most clinicians are likely already encouraging their patients with obesity problems to lose weight, these findings may provide yet another motivation.

"Obviously, obesity leads to a number of cardiovascular conditions," Wang says. The researchers note that earlier studies have connected the onset of AF—enlargement of the upper chambers—with conditions such as obstructive sleep apnea that are linked to obesity. "So we decided to ask whether obesity itself could lead to atrial fibrillation."

For this study, the researchers looked at 5,282 participants (including 2,898 women) with an average age of 57 years who did not have a baseline AF (an electrocardiographic AF or atrial flutter). They examined risk for three categories of body mass index (BMI): normal, defined as <25; overweight, 25–30; and obese, >30.

During an average follow-up of 13.7 years, 526 participants (234 women) developed AF. The incidence rates for AF (adjusted for age) increased across the three BMI categories for both men and women. In models adjusted for cardiovascular risk factors and interim heart attack or heart failure, a 4% increase in AF risk per 1 unit increase in BMI was observed in men. Obese men had a 52% increased risk for AF, while obese women had a 46% increased risk, compared with those with a normal BMI.

One of the surprising findings from this research is that higher risk of AF "is not confined to those who are [morbidly] obese, but [also includes] those who meet the National Institutes of Health definition of obesity [BMI >30]," Wang says. "It turns out that even if you analyze people who aren't obese... there is still a relationship between body mass index and the risk of developing AF.

"The patient-level message [to lose weight] may not change a great deal from what physicians now are telling their patients," Wang says. "But at the public-health level, the message might be that... this burden [of AF morbidity and mortality] may be reduced in this population through prevention of obesity."

References

1. Wang TJ, Parise H, Levy D, et al.: Obesity and the risk of new-onset atrial fibrillation. JAMA 292: 2471–2477, 2004.[Abstract/Free Full Text]

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Services Email this article to a friend Similar articles in this journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Simmons, J. Search for Related Content PubMed Articles by Simmons, J. Social Bookmarking                What's this?