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Genetic Racial Differences and Atrial Fibrillation
Study Questions:
Is the higher prevalence of atrial fibrillation (AF) among whites than blacks explained by genetic factors?
Methods:
Genetic testing for nine single nucleotide polymorphisms (SNPs) associated with AF was performed in 17,325 individuals (4,938 blacks) without a prior history of AF. Incident AF during follow-up was detected using clinic electrocardiograms, hospital discharge summaries, death certificates, and Medicare claims data.
Results:
One SNP (rs10824026) was found to account for 11-32% of the increased incidence of AF in white individuals. No other SNPs that could explain the higher incidence of AF in whites were identified.
Conclusions:
A small portion of the higher risk of AF in whites than blacks is explained by a difference in the prevalence of a SNP. Most of the increased risk of AF in whites is mediated by environmental or other genetic factors.
Perspective:
Prior studies have indicated that black individuals have roughly a 40% lower risk of developing AF compared to white individuals, despite a higher prevalence of risk factors such as hypertension. The reasons for this ‘black paradox’ have been unclear. The present study demonstrates that only a small part of the difference is attributable to one particular SNP (rs10824026), which is protective against AF and which is more prevalent in blacks. The results imply that a genetic and/or environmental factor that is largely responsible for the lower risk of AF in blacks remains unidentified.
Keywords: Arrhythmias, Cardiac, Atrial Fibrillation, African Americans, Electrocardiography, Genetic Testing, Incidence, Medicare, Polymorphism, Single Nucleotide, Prevalence, Risk Factors, Secondary Prevention
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