Body mass index and the risk of new onset atrial fibrillation in middle aged adults.
BACKGROUND Increased body mass index (BMI) and obesity are associated with increased risk of new onset atrial fibrillation (AF) among middle aged adults. OBJECTIVES The objective of the study is to investigate the association between BMI and the risk for new onset AF among middle aged adults. METHODS We investigated 18,290 men and women who were annually screened in a tertiary medical center. Participants were divided at baseline into 3 groups: normal weight (BMI =18 and <25 kg/m(2) n 7,692) overweight (BMI =25 and <30 kg/m(2) n 8,032) and obese (BMI =30 kg/m(2) n 2,566) The primary end point was new onset AF during follow up. RESULTS Mean age of study population was 49 11 years, and 73% were men. A total of 288 incident events (1.6% occurred during 6 4 years. Kaplan Meier survival analysis showed that the cumulative probability of AF at 6 years was highest among obese participants, intermediate among overweight participants, and lowest among participants with normal weight (2.1% 1.7% and 0.8% respectively, P .001) Multivariable Cox regression analysis showed that overweight and obesity were independently associated with increased AF risk (hazard ratio 1.54 [P .004] and 2.41 [P .001] respectively) Assessment of BMI change as a time dependent covariate in the multivariable model showed that each 1 kg/m(2) reduction in BMI during follow up was associated with a significant 7% reduction in the risk for the occurrence of a first AF event (hazard ratio 0.93, 95% CI 0.88 0.99, P .019) Consistently, similar analysis showed that each 5 kg weight loss during follow up was independently associated with a significant 12% reduced risk of new onset AF (95% CI 0.81 0.98, P .02) CONCLUSIONS Our findings suggest that overweight and obesity are associated with increased AF risk, whereas weight reduction is independently associated with reduced risk of de novo AF.
American heart journal