Trends of global burden of atrial fibrillation/flutter from Global Burden of Disease Study 2017

Heart. 2021 Jun;107(11):881-887. doi: 10.1136/heartjnl-2020-317656. Epub 2020 Nov 4.

Abstract

Objective: This study aimed to estimate the global burden of atrial fibrillation/atrial flutter (AF/AFL).

Methods: We retrieved data from the Global Health Data Exchange query tool and estimated the age-standardised rates (ASRs) of prevalence, incidence and disability-adjusted life-years (DALYs) of AF/AFL, as well as the population attributable fraction (PAF) of risk factors contributing to DALYs. ASRs and sociodemographic index (SDI) were assessed using Pearson's correlation coefficients.

Results: In 2017, there were 37.6 million (95% uncertainty interval (UI) 32.5 to 42.6 million) individuals with AF/AFL globally. The prevalence rates increased with increased SDI values in most regions for all years. Men had a higher prevalence than women across all regions except for China. From 1990 to 2017, global prevalence rate decreased by 5.08% (95% UI -6.24% to -3.82%), with the largest decrease noted in the region with high SDI values. The global DALYs rate declined by 2.53% (95% UI -4.16 to -0.29). PAF of elevated systolic blood pressure for attributable DALYs accounted for the highest percentage, followed by high body mass index, alcohol use, high-sodium diet, smoking and lead exposure.

Conclusions: Although the ASRs of prevalence, incidence and DALYs decreased from 1990 to 2017, the absolute number of patients with AF/AFL, annual number of new AF/AFL cases and DALYs lost due to AF/AFL increased. This indicates that the burden of AF/AFL is likely to remain high. Systematic surveillance is needed to better identify and manage AF/AFL so as to prevent its various risk factors and complications.

Keywords: atrial fibrillation; atrial flutter; epidemiology.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology
  • Atrial Fibrillation / epidemiology*
  • Atrial Flutter / epidemiology*
  • Blood Pressure
  • Body Mass Index
  • Disability-Adjusted Life Years
  • Environmental Exposure / adverse effects
  • Global Burden of Disease*
  • Humans
  • Lead / toxicity
  • Male
  • Middle Aged
  • Prevalence
  • Risk Factors
  • Sex Distribution
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Sodium, Dietary / administration & dosage
  • Sodium, Dietary / adverse effects
  • Young Adult

Substances

  • Sodium, Dietary
  • Lead