Sex-specific anthropometric and blood pressure trajectories and risk of incident atrial fibrillation: the Rotterdam Study

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Abstract

AIMS: To investigate sex-specific longitudinal trajectories of various obesity-related measures and blood pressure at the population level and further assess the impact of these trajectories on new-onset atrial fibrillation (AF).

METHODS AND RESULTS: Participants with ≥2 repeated assessments for various risk factors from the population-based Rotterdam Study were included. Latent class linear mixed models were fitted to identify the potential classes. Cox proportional-hazard models were used to assess the association between risk factors' trajectories and the risk of new-onset AF, with the most favourable trajectory as reference. Among 7367 participants (mean baseline age: 73 years, 58.8% women), after a median follow-up time of 8.9 years (interquartile range: 5.3-10.4), 769 (11.4%) participants developed new-onset AF. After adjustments for cardiovascular risk factors, persistent-increasing body mass index (BMI) trajectory carried a higher risk for AF [hazard ratio, 95% confidence interval: (1.39; 1.05-1.85) in men and (1.60; 1.19-2.15) in women], compared with the lower-and-stable BMI trajectory. Trajectories of elevated-and-stable waist circumference (WC) in women (1.53; 1.09-2.15) and elevated-and-stable hip circumference (HC) in men (1.83; 1.11-3.03) were associated with incident AF. For systolic blood pressure (SBP), the initially hypertensive trajectory carried the largest risk for AF among women (1.79; 1.21-2.65) and men (1.82; 1.13-2.95). Diastolic blood pressure trajectories were significantly associated with AF risk among women but not among men.

CONCLUSION: Longitudinal trajectories of weight, BMI, WC, HC, and SBP were associated with new-onset AF in both men and women. Diastolic blood pressure trajectories were additionally associated with AF in women. Our results highlight the importance of assessing long-term exposure to risk factors for AF prevention among men and women.

Original languageEnglish
Pages (from-to)1744-1755
Number of pages12
JournalEuropean Journal of Preventive Cardiology
Volume29
Issue number13
DOIs
Publication statusPublished - 1 Sept 2022

Bibliographical note

Funding Information:
The Rotterdam Study is supported by Erasmus Medical Center and Erasmus University, Rotterdam; the Netherlands Organization for Scientific Research (NWO); the Netherlands Organization for Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly (RIDE); the Netherlands Genomics Initiative; the Ministry of Education, Culture and Science; the Ministry of Health, Welfare and Sport; the European Commission (DG XII); and the Municipality of Rotterdam. This study is further supported by the Gender and Prevention grant (555003017) from ZonMw. Z.L. is a recipient of a scholarship under the China Scholarship Council (CSC) (201906940022). None of the funders had any role in the design and conduct of the study; the collection, management, analysis, and interpretation of the data; and in the preparation, review, or approval of the manuscript.

Publisher Copyright:
© 2022 The Author(s).

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