Introduction Atrial fibrillation (AF) is the most common arrhythmia encountered in the Western World and it can affect up to 17% of patients over the age of 80. In Ireland our population 85 years and over are increasing at a rate of 4% per year. Currently, there is evidence that lifestyle risk factors may play a significant role in the pathophysiology of atrial fibrillation.
Purpose To identify the prevalence of atrial fibrillation among the elderly population 65 years and over, attending General Practice and explore the associations with lifestyle risk factors.
Methods This multi-site prospective observational study was carried out between 1st January 2014 and 30th June 2014. 89 General Practitioners from the West of Ireland participated in the study. All patients≥65 years underwent opportunistic screening for AF by pulse palpation confirmed on 12 lead ECG. Demographic and lifestyle characteristics on all patients were analysed using a logit binary dependent model. Variables were added in a stepwise fashion according to known associations.
Results 7262 patients were included in the study. AF was identified in 804 patients. Demographic variables and lifestyle risk factors in the 2 groups are shown in table 1. Age was associated with the likelihood of having AF, with an increase in the odds of AF of 1.08 with each yearly increase in age. Gender was strongly associated with the presence of AF, with the odds of having AF among males 1.81 times higher than females (p<0.00). Among lifestyle characteristics, alcohol had the strongest association, with the odds of having AF being 1.78 times higher in the group with the highest level of alcohol consumption when compared to the non-drinking group (p<0.05). The odds of AF among current smokers was less than that observed in the never smoked group (OR 0.66; p<0.05) (table 2).
Conclusions As with previous studies in this area, age, gender and high levels of alcohol consumption were associated with an increased likelihood of AF in this group. Though the absolute increase was small, the likelihood of AF was shown to increase with each yearly increase in age among this population. Gender was strongly associated with AF, with males being almost twice as likely to have AF when compared to females. High levels of alcohol consumption were associated with an increased likelihood of AF with the odds of AF being almost twice as high in the group consuming more than 21 units per week when compared to the non-drinking group. The observed association with smoking status was unexpected, and may relate to a higher baseline prevalence of smoking in the group of patients without AF. These results highlight the often forgotten impact of alcohol on the prevalence of AF in the elderly population that so frequently translates into stroke and subsequent morbidity, mortality and financial cost imposed on the health service. Our data suggests that addressing alcohol consumption in the elderly may have a significant effect on reducing prevalence of AF in this population.
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