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European Heart Journal Advance Access published online on March 20, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp076
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Big men and atrial fibrillation: effects of body size and weight gain on risk of atrial fibrillation in men

Annika Rosengren1,*, Paul J Hauptman2, Georg Lappas1, Lars Olsson3, Lars Wilhelmsen4 and Karl Swedberg1

1 Department of Medicine, Sahlgrenska University Hospital/Östra, Göteborg SE-416 85, Sweden
2 Division of Cardiology, Saint Louis University Hospital, St Louis, MO, USA
3 Department of Medicine, Mora Hospital, Mora, Sweden
4 Preventive Cardiology, Göteborg University, Göteborg, Sweden

Received 4 October 2008; revised 30 December 2008; accepted 5 February 2009 * Corresponding author. Tel: +46 31 343 4100, Fax: +46 31 25 89 33, Email: annika.rosengren{at}gu.se

Aims: Obesity is a recognized risk factor for atrial fibrillation (AF), partly because of the association between body mass index (BMI) and atrial volume. We aimed to determine whether other factors relating to body size were related to AF.

Methods and results: Data were derived from a random population sample of 6903 men (mean age 51.5 years) who underwent a single midlife evaluation as part of the multifactor Swedish Primary Prevention Study. A total of 1253 men (18.2%) had a subsequent hospital discharge diagnosis (principal or secondary) of AF during a maximum follow-up of 34.3 years. Body surface area (BSA) at age 20 (calculated from recalled weight and measured height) was strongly related to subsequent AF (P < 0.0001), as were midlife BMI and weight gain from age 20 to midlife (P < 0.0001). In a Cox regression model which adjusted for midlife BMI, weight gain and other risk factors, hazard ratios (HR) [95% confidence intervals (CI)] for AF for the second, third, and fourth quartile of BSA at age 20, compared with the lowest quartile, were 1.47 (95% CI, 1.22–1.76), 1.66 (95% CI, 1.38–2.00), and 2.22 (95% CI, 1.82–2.70) (P for trend <0.0001).

Conclusion: Large body size in youth, in an era when obesity was rare, as well as weight gain from age 20 to midlife, were both independently related to the development of AF. Given the current trends not only for obesity but also for height, a substantial increase in the incidence of AF is likely.

Key Words: Atrial fibrillation • Obesity • Body size • Stature


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Body size and atrial fibrillation: only in healthy subjects?
Carlos Escobar, et al.
European Heart Journal, 26 Nov 2009 [Full text]

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