From the Guidelines
Atrial fibrillation (AFib) is strongly associated with several risk factors, including advancing age, smoking, physical inactivity, alcohol consumption, adiposity markers, hypertension, and increased height.
Risk Factors for Atrial Fibrillation
The following are established risk factors for AFib:
- Advancing age: The risk of AFib increases with age, with a hazard ratio (HR) of 1.43-1.66 per 5-year increase in age 1
- Smoking: Smoking is a significant risk factor for AFib, with a HR of 1.21-1.43 1
- Physical inactivity: A sedentary lifestyle is associated with an increased risk of AFib, with an odds ratio (OR) of 2.47 1
- Alcohol consumption: Alcohol consumption is a risk factor for AFib, with a dose-response relationship, and a relative risk (RR) of 1.08-1.47 per drink per day 1
- Adiposity markers: Obesity is a significant risk factor for AFib, with a population attributable fraction of 12.7-16.9% 1
- Hypertension: Elevated blood pressure is a risk factor for AFib, with a HR of 1.35-1.68 1
- Increased height: Increased height is associated with an increased risk of AFib, with a HR of 1.28 per 10 cm increase in height 1 These risk factors are supported by multiple studies, including the 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation 1 and the 2024 ESC guidelines for the management of atrial fibrillation 1.
Lifestyle Modifications
Lifestyle modifications, such as weight loss, increased physical activity, and alcohol avoidance or reduction, can help reduce the risk of AFib and improve outcomes in patients with AFib 1.
Clinical Implications
These risk factors have important clinical implications for the diagnosis, management, and prevention of AFib. Healthcare providers should consider these risk factors when evaluating patients for AFib and develop strategies to mitigate them.
From the Research
Risk Factors for Atrial Fibrillation (AFib)
The development and progression of atrial fibrillation (AFib) are influenced by various modifiable lifestyle risk factors, including:
- Obesity
- Hypertension
- Hypercholesterolemia
- Diabetes mellitus
- Smoking
- Chronic obstructive pulmonary disease
- Alcohol consumption
- Exercise
- Sedentary lifestyle
- Obstructive sleep apnea 2, 3, 4
Modifiable Risk Factors
Modifiable cardiovascular risk factors that contribute to the development and progression of AFib include:
- Obesity
- Hypertension
- Diabetes mellitus
- Obstructive sleep apnea
- Alcohol consumption
- Smoking
- Sedentary lifestyles 5, 3, 4
Lifestyle Interventions
Lifestyle interventions can reduce predisposing factors, reverse the pathophysiology behind AFib, and decrease disease burden 5, 4
- Targeted prevention strategies can be effective in primary and secondary AFib prevention
- A structured, protocol-driven multidisciplinary approach to integrate lifestyle and risk factor management can help in the prevention and treatment of AFib 4
Epidemiology and Prevention
The global prevalence of AFib has increased substantially over the past three decades, with approximately 60 million cases worldwide 6