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.


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