Prevalence and risk factors of atrial fibrillation in Germany. Data from the Gutenberg Health Study

Atrial fibrillation (AF) is a disease with increasing clinical and public health importance. We describe the prevalence of AF, the current distribution of AF risk factors and their importance in a general population. The distribution of AF risk factors and the medicinal treatment were determined among 10,000 individuals in the population-based Gutenberg Health Study (median age 56 years and 49% women). Individuals with AF (n=309, 3.1%) had a higher median age (67 years) and significantly more risk factors. A large percentage of individuals with AF were taking antithrombotic medication (84% with a CHAD(2)DS(2)-VASc score of a parts per thousand yen3). Multiple logistic regression analysis showed that male gender (odds ratio, OR 2.07, 95% CI: 1.59-2.71), age (OR 1.09, 95% CI: 1.07-1.11), body mass index (OR 1.04, 95% CI: 1.02-1.07), prevalent cardiovascular disease (OR 3.06, 95% CI: 2.26-4.11) and heart failure (OR 3.11, 95% CI: 1.92-4.97) were the strongest predictors of AF. The full model explained 18% (Nagelkerke's determination coefficient R-2) of the variation in AF prevalence. The addition of echocardiographic variables in a subgroup analysis with 5.000 participants increased the explained variation to 23%. AF is a common disease in the general population. Important risk factors for AF, apart from age and male gender, were cardiovascular disease, in particular heart failure, hypertension and increased body mass index. Awareness for AF in the population and medical community needs to be improved.