Skip to main content
PMC home page
Heart logoLink to Heart
. 2001 Nov;86(5):516–521. doi: 10.1136/heart.86.5.516

Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study

S Stewart 1, C Hart 1, D Hole 1, J McMurray 1
PMCID: PMC1729985  PMID: 11602543

Abstract

OBJECTIVES—Though atrial fibrillation (AF) is an important cause of cardiovascular morbidity, there are few large epidemiological studies of its prevalence, incidence, and risk factors. The epidemiological features of AF are described in one of the largest population cohorts ever studied.
METHODS—The prevalence and incidence of AF were studied in the Renfrew/Paisley population cohort of 15 406 men and women aged 45-64 years living in the west of Scotland. This cohort was initially screened between 1972 and 1976 and again between 1977 and 1979. Incident hospitalisations with AF in the 20 year period following initial screening were also studied.
RESULTS—The population prevalence of AF in this cohort was 6.5 cases/1000 examinations. Prevalence was higher in men and older subjects. In those who were rescreened, the four year incidence of AF was 0.54 cases/1000 person years. Radiological cardiomegaly was the most powerful predictor of new AF (adjusted odds ratio 14.0). During 20 year follow up, 3.5% of this cohort was discharged from hospital with a diagnosis of AF; the rate of incident hospitalisation for AF was 1.9 cases/1000 person years. Radiological cardiomegaly (adjusted odds ratio 1.46) and systolic blood pressure (adjusted odds ratio 2.1 for ⩾ 169 mm Hg) were independent predictors of this outcome.
CONCLUSIONS—Data from one of the largest epidemiological studies ever undertaken confirm that AF has a large population prevalence and incidence, even in middle aged people. More important, it was shown that the long term incidence of hospitalisation related to AF is high and that two simple clinical measurements are highly predictive of incident AF. These findings have important implications for the prevention of AF.


Keywords: atrial fibrillation; epidemiology; systolic blood pressure; cardiac volume

Full Text

The Full Text of this article is available as a PDF (129.4 KB).

Figure 1  .

Figure 1  

Open in a new tab

Age and sex specific prevalence of atrial fibrillation (AF) in a population cohort from the west of Scotland.

Figure 2  .

Figure 2  

Open in a new tab

Rate of new incident cases of AF detected during rescreening of 8532 men and women (34 891 person years of follow up). (Age groups are based on age at baseline.)

Figure 3  .

Figure 3  

Open in a new tab

Rate of incident AF hospitalisation in 15 306 men and women during 20 year follow up. (Age groups are based on age at baseline.)

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Benjamin E. J., Levy D., Vaziri S. M., D'Agostino R. B., Belanger A. J., Wolf P. A. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA. 1994 Mar 16;271(11):840–844. [PubMed] [Google Scholar]
  2. Boysen G., Nyboe J., Appleyard M., Sørensen P. S., Boas J., Somnier F., Jensen G., Schnohr P. Stroke incidence and risk factors for stroke in Copenhagen, Denmark. Stroke. 1988 Nov;19(11):1345–1353. doi: 10.1161/01.str.19.11.1345. [DOI] [PubMed] [Google Scholar]
  3. Furberg C. D., Psaty B. M., Manolio T. A., Gardin J. M., Smith V. E., Rautaharju P. M. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol. 1994 Aug 1;74(3):236–241. doi: 10.1016/0002-9149(94)90363-8. [DOI] [PubMed] [Google Scholar]
  4. Harley K., Jones C. Quality of Scottish Morbidity Record (SMR) data. Health Bull (Edinb) 1996 Sep;54(5):410–417. [PubMed] [Google Scholar]
  5. Hart C. L., Hole D. J., Smith G. D. Risk factors and 20-year stroke mortality in men and women in the Renfrew/Paisley study in Scotland. Stroke. 1999 Oct;30(10):1999–2007. doi: 10.1161/01.str.30.10.1999. [DOI] [PubMed] [Google Scholar]
  6. Hawthorne V. M., Watt G. C., Hart C. L., Hole D. J., Smith G. D., Gillis C. R. Cardiorespiratory disease in men and women in urban Scotland: baseline characteristics of the Renfrew/Paisley (midspan) study population. Scott Med J. 1995 Aug;40(4):102–107. doi: 10.1177/003693309504000402. [DOI] [PubMed] [Google Scholar]
  7. Hemingway H., Shipley M., Christie D., Marmot M. Cardiothoracic ratio and relative heart volume as predictors of coronary heart disease mortality. The Whitehall study 25 year follow-up. Eur Heart J. 1998 Jun;19(6):859–869. doi: 10.1053/euhj.1997.0862. [DOI] [PubMed] [Google Scholar]
  8. Hole D. J., Watt G. C., Davey-Smith G., Hart C. L., Gillis C. R., Hawthorne V. M. Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ. 1996 Sep 21;313(7059):711–716. doi: 10.1136/bmj.313.7059.711. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kannel W. B., Abbott R. D., Savage D. D., McNamara P. M. Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Engl J Med. 1982 Apr 29;306(17):1018–1022. doi: 10.1056/NEJM198204293061703. [DOI] [PubMed] [Google Scholar]
  10. Kendrick S., Clarke J. The Scottish Record Linkage System. Health Bull (Edinb) 1993 Mar;51(2):72–79. [PubMed] [Google Scholar]
  11. Krahn A. D., Manfreda J., Tate R. B., Mathewson F. A., Cuddy T. E. The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. Am J Med. 1995 May;98(5):476–484. doi: 10.1016/S0002-9343(99)80348-9. [DOI] [PubMed] [Google Scholar]
  12. Langenberg M., Hellemons B. S., van Ree J. W., Vermeer F., Lodder J., Schouten H. J., Knottnerus J. A. Atrial fibrillation in elderly patients: prevalence and comorbidity in general practice. BMJ. 1996 Dec 14;313(7071):1534–1534. doi: 10.1136/bmj.313.7071.1534. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Onundarson P. T., Thorgeirsson G., Jonmundsson E., Sigfusson N., Hardarson T. Chronic atrial fibrillation--epidemiologic features and 14 year follow-up: a case control study. Eur Heart J. 1987 May;8(5):521–527. doi: 10.1093/oxfordjournals.eurheartj.a062312. [DOI] [PubMed] [Google Scholar]
  14. Psaty B. M., Manolio T. A., Kuller L. H., Kronmal R. A., Cushman M., Fried L. P., White R., Furberg C. D., Rautaharju P. M. Incidence of and risk factors for atrial fibrillation in older adults. Circulation. 1997 Oct 7;96(7):2455–2461. doi: 10.1161/01.cir.96.7.2455. [DOI] [PubMed] [Google Scholar]
  15. ROSE G. A. The diagnosis of ischaemic heart pain and intermittent claudication in field surveys. Bull World Health Organ. 1962;27:645–658. [PMC free article] [PubMed] [Google Scholar]
  16. Sandvik L., Erikssen J., Thaulow E., Erikssen G., Mundal R., Aakhus T. Heart volume and cardiovascular mortality. A 16 year follow-up study of 1984 healthy middle-aged men. Eur Heart J. 1993 May;14(5):592–596. doi: 10.1093/eurheartj/14.5.592. [DOI] [PubMed] [Google Scholar]
  17. Wolf P. A., Abbott R. D., Kannel W. B. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991 Aug;22(8):983–988. doi: 10.1161/01.str.22.8.983. [DOI] [PubMed] [Google Scholar]
  18. Wolf P. A., Benjamin E. J., Belanger A. J., Kannel W. B., Levy D., D'Agostino R. B. Secular trends in the prevalence of atrial fibrillation: The Framingham Study. Am Heart J. 1996 Apr;131(4):790–795. doi: 10.1016/s0002-8703(96)90288-4. [DOI] [PubMed] [Google Scholar]

Articles from Heart are provided here courtesy of BMJ Publishing Group

RESOURCES