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  •    Young People of the world Beware! Your body mass Index and weight gain can place you at a high risk for Atrial Fibrillation in Future


    Atrial Fibrillation(AF) is associated with significant morbidity and mortality. Factors that determine the development of AF are studied to reduce the incidence of AF in the people. Few of the known variables that can increase the risk of AF are structural heart disease, coronary heart disease and hypertension. A few of the recent studies have clearly shown the adverse effects of Body mass Index (BMI) and obesity on the incidence of AF. These factors can influence the occurrence of AF by altering the left atrail volume. A Recent study published in European Heart Journal confirms the impact of body size and weight gain on AF( Annika Rosengren1*, Paul J. Hauptman, Georg Lappas, Lars Olsson, Lars Wilhelmsen, and Karl Swedberg Big men and atrial fibrillation: effects of body size and weight gain on risk of atrial fibrillation in me 2009 European Heart Journal (2009) 30, 1113–1120.)

    Data for this study was gathered from men participating in intervention group of the multifactor primary prevention study, which started in Goteborg, Sweden in 1970.All the men in the study were born between 1915 and 1925.The screening examination took place between January 1970 and march 1973 at which time men ranged in age from 47 to 56 years. Some of the variables collected at the time of midlife evaluation were recalled weight at age 20, smoking history, physical activity during leisure time (categorized as sedentary, moderate activity, or regular strenuous activity), and treatment of diabetes, hypertension and alcohol history. These patients were followed over the subsequent years for the development of AF.

    The average recalled weight at the age 20 was 69.1kgs, with an estimated BMI of 22.4 and mean change in weight from youth to midlife of 14.7kgs. These people were followed for a maximum period of 34.3 years and 18.2% of people developed either for primary or secondary AF. As expected the cardiovascular risk increased in people with high BMI. Body surface area and height were other variables found to increase the risk of AF.BMI and BSA recorded in midlife are inseparably related to weight gain from the age of 20 to the midlife. In order to find the role of height and BSA separately, weight gained from the age of 20 to midlife is calculated. Height and BSA of the people measured in their early twenties were found to play an independent role in the incidence of AF.

    Several studies have noted a relationship between body height and AF. In a recent large cross-sectional study of patients with reduced left ventricular ejection fraction, the effect of height on the AF risk persisted after adjusting the clinical and demographical variables, with an estimated 3%increaase in risk per cm increase in height. The probable explanation for that is the relation of the height and BSA with the left atrial size of the patients. In conclusion, BSA at the age of 20 and the weight gain from the age of 20 to midlife is associated with AF. Obesity with manifest increase in BMI and BSA is a worldwide epidemic and has greater implications on the overall health of people. This obviously raises the possibility of increased incidence of AF in the years to come.

    References

    1. Benjamin EJ, Levy D, Vaziri SM, D’Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA 1994;271:840–844.

    2. Psaty BM, Manolio TA, Kuller LH, Kronmal RA, Cushman M, Fried LP, White R, Furberg CD, Rautaharju PM. Incidence of and risk factors for atrial fibrillation in older adults. Circulation 1997;96:2455–2461.

    3. Stewart S, Hart CL, Hole DJ, McMurray JJ. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart 2001;86:516–521.

    4. Wilhelmsen L, Rosengren A, Lappas G. Hospitalizations for atrial fibrillation in the general male population: morbidity and risk factors. J Intern Med 2001;250:382–389.

    5. Mitchell GF, Vasan RS, Keyes MJ, Parise H, Wang TJ, Larson MG, D’Agostino RB Sr, Kannel WB, Levy D, Benjamin EJ. Pulse pressure and risk of new-onset atrial fibrillation. JAMA 2007;297:709–715.

    6. Wang TJ, Parise H, Levy D, D’Agostino RB Sr, Wolf PA, Vasan RS, Benjamin EJ. Obesity and the risk of new-onset atrial fibrillation. JAMA 2004;292:2471–2477.


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