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Racial Differences in Incidence and Clinical Course of Atrial Fibrillation and What Remains to be Investigated

  • Race + Ethnicity Disparities (K Watson, Section Editor)
  • Published:
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Abstract

There are many risk factors identified for atrial fibrillation (AF), some of which differ between blacks and whites. These differences and differences in stroke occurrence and clinical course of AF between blacks and whites are reviewed. Risk factors identified to date include age, white race, male sex, body mass index (BMI) ≥30, height ≥173 cm, weight, increased waist circumference, higher levels of systolic (SBP) and diastolic blood pressure (DBP), increased pulse pressure, diagnosis of hypertension, antihypertensive medication use, HDL <40 mg/dL, triglycerides >200 mg/dL, lower heart rate, P-R interval >200 ms, ECG left ventricular hypertrophy (LVH), ECG left atrial enlargement (LAE), diabetes, coronary artery disease (CAD), heart failure, low birth weight, cystatin C, NT-proBNP, forced expiratory volume (FEV1), left ventricular wall thickness, SES, chronic kidney disease, serum Mg, C-reactive protein, serum uric acid, smoking, serum phosphorus, calcium-phosphorus product, serum aldosterone, and galactin-3. Some genes have been associated with some of the risk factors with different occurrence rates in blacks and whites. The distribution of some of the risk factors has also been shown to differ in effect and frequency between blacks and whites. Hospital treatment of AF has also been seen to differ between blacks and whites. Various combinations of risk factors have been assembled and tested—none have explained more than 65 % of AF risk nor have any groupings of risk factors been shown to differ in risk of AF between blacks and whites, although individual risk factors have shown differences of effect on AF risk between the races. No studies have collected all of these risk factors together in one study so far and the need for such studies is set out with recommendations for other investigative studies not yet undertaken to explain the differences in AF and stroke types and rates between blacks and whites.

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Conflict of Interest

Ronald J Prineas and Elsayed Z Soliman declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Division of Public Health Sciences, Department of Epidemiology and prevention, Wake Forest University School of Medicine, Winston Salem, NC, USA

    Ronald J. Prineas & Elsayed Z. Soliman

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  1. Ronald J. Prineas
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Correspondence to Ronald J. Prineas.

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This article is part of the Topical Collection on Race + Ethnicity Disparities

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Prineas, R.J., Soliman, E.Z. Racial Differences in Incidence and Clinical Course of Atrial Fibrillation and What Remains to be Investigated. Curr Cardiovasc Risk Rep 9, 2 (2015). https://doi.org/10.1007/s12170-014-0433-2

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  • DOI: https://doi.org/10.1007/s12170-014-0433-2

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