Prevalence of atrial fibrillation and cardiovascular risk factors in a 63-65 years old general population cohort: The Akershus Cardiac Examination (ACE) 1950 Study

Trygve Berge, Magnus Nakrem Lyngbakken, Håkon Ihle-Hansen, Jon Brynildsen, Mohammad Osman Pervez, Erika Nerdrum Aagaard, Thea Vigen, Brede Kvisvik, Ingrid Elisabeth Christophersen, Kjetil Steine, Torbjørn Omland, Pål Smith, Helge Røsjø, Arnljot Tveit

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Objectives To investigate the sex-specific prevalence of atrial fibrillation (AF), including subclinical AF found by screening in a general population aged 63-65 years. The prevalence of cardiovascular risk factors and their association with AF will also be investigated. Design Cross-sectional analysis of an observational, prospective, longitudinal, population-based cohort study. Setting General population in Akershus county, Norway. Participants Women and men born in 1950. We included 3706 of 5827 eligible individuals (63.6%); 48.8% were women. Methods All participants underwent extensive cardiovascular examinations, including 12-lead ECG. History of AF and other cardiovascular diseases were self-reported. Subsequent validation of all reported or detected AF diagnoses was performed. Results Mean age was 63.9±0.7 years. Prevalence of ECG-verified AF was 4.5% (women 2.4%, men 6.4%; p<0.001), including screen-detected AF in 0.3% (women 0.1%, men 0.6%; p<0.01). Hypertension was found in 62.0% (women 57.8%, men 66.0%; p<0.001). Overweight or obesity was found in 67.6% (women 59.8%, men 74.9%; p<0.001). By multivariate logistic regression, risk factors associated with AF were height (OR 1.67 per 10 cm; 95% CI 1.26 to 2.22; p<0.001), weight (OR 1.15 per 10 kg; 95% CI 1.01 to 1.30; p=0.03), hypertension (OR 2.49; 95% CI 1.61 to 3.86; p<0.001), heart failure (OR 3.51; 95% CI 1.71 to 7.24; p=0.001), reduced estimated glomerular filtration rate (OR 2.56; 95% CI 1.42 to 4.60; p<0.01) and at least one first-degree relative with AF (OR 2.32; 95% CI 1.63 to 3.31; p<0.001), whereas male sex was not significantly associated (OR 1.00; 95% CI 0.59 to 1.68; p=0.99). Conclusion In this cohort from the general population aged 63-65 years, we found a higher prevalence of known AF than previously reported below the age of 65 years. The additional yield of single time point screening for AF was low. Body size and comorbidity may explain most of the sex difference in AF prevalence at this age. Trial registration number NCT01555411; Results.

Original languageEnglish
Article numbere021704
JournalBMJ Open
Issue number7
StatePublished - 1 Jul 2018
Externally publishedYes


  • atrial fibrillation
  • cardiac epidemiology
  • cardiovascular risk
  • obesity
  • prevalence
  • screening


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