Incident Atrial Fibrillation Among Asians, Hispanics, Blacks, and Whites

Study Questions:

Does race influence the probability of developing atrial fibrillation (AF)?


The Healthcare Cost and Utilization Project database of hospitalizations in California was queried to identify 375,318 cases of incident AF from among 13,967,949 patients during a median of 3.2 years. Atrial flutter (AFl) was considered separately from AF. Multiple variables including race were analyzed to determine the predictors of AF.


The overall incidence of AF was 9.03 per 1,000 patient-years. After adjusting for comorbidities, the probability of incident AF was significantly lower among Blacks (odds ratio [OR], 0.53), Hispanics (OR, 0.61), and Asians (OR, 0.68) compared to Whites. The racial disparity between Whites and the other racial groups was amplified in the absence of comorbidities and attenuated in the presence of comorbidities. There were 68,670 cases of incident AFl. AFl was significantly more likely in Blacks (OR, 1.09) and lower in Hispanics (OR, 0.71) and Asians (OR, 0.81) compared to Whites.


The authors concluded that the risk of developing AF is higher in Whites than in other racial groups.


Several prior studies have reported that the incidence of AF is higher in Whites than Blacks, and the reasons for this have been unclear. The results of this study demonstrate that Whites also are at greater risk of AF than Hispanics and Asians. This suggests that genetic or environmental factors unique to Whites contribute to the racial disparity. In addition, the results indicate that a protective factor unique to Blacks does not explain the lower incidence of AF in Blacks than Whites.

Clinical Topics: Arrhythmias and Clinical EP, Atrial Fibrillation/Supraventricular Arrhythmias

Keywords: Encephalitis Virus, Japanese, California, Health Care Costs, Hispanic Americans, African Continental Ancestry Group, Hospitalization, Pregnancy, Atrial Flutter, Asian Continental Ancestry Group

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