The age-specific impact of atrial fibrillation (AF) on cardiovascular diseases remains
unclear. A total of 90,629 participants who were from 40 to 79 years of age in 1993
were followed up until 2013 as part of the Ibaraki Prefectural Health Study. Hazard
ratios for mortality stratified by gender and age groups were calculated using Cox's
proportional hazards regression models. A total of 22,794 patients (11,329 men and
11,465 women) died during the follow-up period, including 6,684 patients who died
of cardiovascular causes (2,951 men and 3,733 women). On multivariable analysis, participants
with AF had an increased risk of cardiovascular-related mortality compared with those
without AF. Among participants aged 40 to 64 years, the adjusted hazard ratios were
3.2 (95% confidence interval [CI] 2.0 to 5.3) for men and 7.1 (95% CI 3.2 to 16.0)
for women; the corresponding adjusted hazard ratios among participants aged 65 to
79 years were 3.0 (95% CI 2.2 to 4.0) for men and 3.7 (95% CI 2.5 to 5.4) for women.
No significant difference in hazard ratios between age groups was found for either
gender. AF was significantly associated with all-cause mortality in each age and gender
group; again, no significant difference in hazard ratios between the age groups was
found in terms of AF. AF may be an independent risk factor for cardiovascular and
all-cause mortalities regardless of age.
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References
- World Health Statistics 2016: Monitoring Health for the SDGs, Sustainable Development Goals.WHO Press, Geneva2016
- Atrial fibrillation and mechanisms of stroke: time for a new model.Stroke. 2016; 47: 895-900
- Risk of death and cardiovascular events in initially healthy women with new-onset atrial fibrillation.JAMA. 2011; 305: 2080-2087
- The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study.Am J Med. 1995; 98: 476-484
- Relative and absolute risks of all-cause and cause-specific deaths attributable to atrial fibrillation in middle-aged and elderly community dwellers.Int J Cardiol. 2015; 184: 692-698
- Mortality risk attributable to atrial fibrillation in middle-aged and elderly people in the Japanese general population: nineteen-year follow-up in NIPPON DATA80.Circ J. 2007; 71: 814-819
- Long-term cardiovascular outcomes in patients with atrial fibrillation and atherothrombosis in the REACH Registry.Int J Cardiol. 2014; 170: 413-418
- A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study.Am J Med. 2002; 113: 359-364
- Prevalence of atrial fibrillation in the general population of Japan: an analysis based on periodic health examination.Int J Cardiol. 2009; 137: 102-107
- Rapid increase in estimated number of persons with atrial fibrillation in Japan: an analysis from national surveys on cardiovascular diseases in 1980, 1990 and 2000.J Epidemiol. 2005; 15: 194-196
- Evidence for cardiovascular prevention from observational cohorts in Japan Research G. Relation of blood pressure and all-cause mortality in 180,000 Japanese participants: pooled analysis of 13 cohort studies.Hypertension. 2008; 51: 1483-1491
- Age-specific relationship between blood pressure and the risk of total and cardiovascular mortality in Japanese men and women.Hypertens Res. 2005; 28: 901-909
- 2017 Vital Statistics of Japan, Volume 3, Table 2 Deaths by Causes (the Condensed List of Causes of Death for Japan), Sex and Age: Japan Vital Statistics of Japan.Ministry of Health, Labour and Welfare, Tokyo, Japan2018
- Mild retinopathy is a risk factor for cardiovascular mortality in Japanese with and without hypertension: the Ibaraki Prefectural Health Study.Circulation. 2011; 124: 2502-2511
- Atrial fibrillation prevalence, incidence and risk of stroke and all-cause death among Chinese.Int J Cardiol. 2010; 139: 173-180
- Risk of stroke in non-rheumatic atrial fibrillation.Lancet. 1987; 1: 526-529
- Epidemiologic features of chronic atrial fibrillation: the Framingham study.N Engl J Med. 1982; 306: 1018-1022
- Impact of hypertension and subclinical organ damage on the incidence of cardiovascular disease among Japanese residents at the population and individual levels—the Circulatory Risk in Communities Study (CIRCS).Circ J. 2017; 81: 1022-1028
- Risk of stroke and heart failure attributable to atrial fibrillation in middle-aged and elderly people: results from a five-year prospective cohort study of Japanese community dwellers.J Epidemiol. 2017; 27: 360-367
- Incidence and risk factors for subtypes of cerebral infarction in a general population: the Hisayama study.Stroke. 2000; 31: 2616-2622
- Atrial fibrillation as an independent risk factor for stroke: the Framingham Study.Stroke. 1991; 22: 983-988
- Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham study.Neurology. 1978; 28: 973-977
- The mechanism of and preventive therapy for stroke in patients with atrial fibrillation.J Stroke. 2016; 18: 129-137
- Advanced age, anticoagulation intensity, and risk for intracranial hemorrhage among patients taking warfarin for atrial fibrillation.Ann Intern Med. 2004; 141: 745-752
- New oral anticoagulants and the risk of intracranial hemorrhage: traditional and Bayesian meta-analysis and mixed treatment comparison of randomized trials of new oral anticoagulants in atrial fibrillation.JAMA Neurol. 2013; 70: 1486-1490
- Risk profile and 1-year outcome of newly diagnosed atrial fibrillation in Japan-insights from GARFIELD-AF.Circ J. 2018; 83: 67-74
- Stroke incidence and case fatality in Shiga, Japan 1989-1993.Int J Epidemiol. 1999; 28: 1059-1065
- A population-based study of the proportion by type of stroke determined by computed tomography scan (in Japanese).Nippon Koshu Eisei Zasshi. 1991; 38: 901-909
Article info
Publication history
Published online: August 08, 2019
Received in revised form:
July 18,
2019
Received:
May 22,
2019
Footnotes
Sources of Funding: This work was supported by a Grant-in-Aid from the Ministry of Health, Labour and Welfare, Health and Labour Sciences Research Grants, Japan (Research on Health Services: H17-Kenkou-007; Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H18-Junkankitou[Seishuu]-Ippan-012; Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H20-Junkankitou[Seishuu]-Ippan-013; Intractable Diseases Conquest Research: H21-Nanchi-Ippan-059; Comprehensive Research on Cardiovascular and Life-Style Related Diseases: H23-Junkankitou[Seishuu]-Ippan-005; an Intramural Research Fund (22-4-5) for Cardiovascular Diseases of National Cerebral and Cardiovascular Centre; and Comprehensive Research on Cardiovascular and Life-Style-Related Diseases: H26-Junkankitou [Seisaku]-Ippan-001 and H29-Junkankitou [Seishuu]-Ippan-003) as well as a Grant-in-Aid from the Japan Agency for Medical Research and Development (AMED) (grant number: JP18ek0210082).
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