Comparing Risk Factors for Atrial Fibrillation Between Young and Old Patients

Researchers aiming to understand the effects of known risk factors for occurrence of atrial fibrillation (AFib) relative to patients’ age observed a different risk profile for AFib development in individuals aged less than 60 years versus those aged 60 years or more. Their findings were published in PLoS One.


“Compared to the ≥60 years group, relatively modifiable risk factors (such as obesity and hypertension) had a greater impact on AFib incidence in the <60 years age group,” according to co-lead authors, In-Soo Kim, MD, and Yeon-Jik Choi, MD. “Different management strategies to prevent AF development according to age may be needed,” Kim and Choi concluded.

The researchers analyzed data from 501,668 subjects aged 18 years or more without AFib and valvular heart disease from the Korean National Health Insurance Service-National Sample Cohort.


The patients were divided according to age: less than 60 years and 60 or more years. AFib occurred in 0.7% of the overall population (3,416 of 501,668 total patients) during the follow-up period (mean 47.6 months). Age, male sex, previous ischemic stroke, heart failure, and hypertension were associated with an increased risk of new-onset AFib in both groups.


Investigators highlighted that risk of new-onset AF in the less than 60 years age group was especially increased by the manageable risk factors of obesity (body mass index ≥25kg/m2; hazard ratio [HR] = 1.37, 95% confidence interval [CI] 1.22–1.55, P = 0.001), and hypertension (HR = 1.93, 95% CI 1.69–2.22, P = 0.001).


Given their findings, the study’s authors proposed that the AFib progression may be related to age and called for prospective studies to confirm the association. Additionally, they noted that risk of AFib development can be reduced with management of weight and hypertension, particularly in patients less than 60 years old.