This article is more than 5 years old. Information may no longer be current.
AF rates in US adults likely to double by 2030
Click Here to Manage Email Alerts
The incidence and prevalence of atrial fibrillation have increased steadily in the past decade, and current estimates suggest that rates will double from 2010 to 2030, according to data from a large longitudinal study.
Using a simulation progression model, researchers projected that the incidence of AF in the US adult population will rise from 1.2 million cases in 2010 to 2.6 million cases in 2030, and the prevalence of AF will rise from 5.2 million cases in 2010 to 12.1 million cases in 2030.
The data suggest “that both the AF incidence and prevalence are increasing at a steady pace in the US population and may indicate that the public health burden of AF may reach concerning levels by 2013,” Susan Colilla, PhD, MPH, a global health economist and outcomes researcher for Bristol-Myers Squibb, and colleagues wrote. “Further research is needed to investigate what factors may be contributing to this increasing trend in AF incidence and prevalence.”
Colilla and colleagues conducted the large longitudinal study to estimate the incidence and prevalence of AF and project rates over time. They analyzed a geographically diverse health insurance claims database that included 14 million individuals, representing 5% of the US population. Projections were based on incident AF cases diagnosed from January 2002 to June 2007.
In those 5 years, the AF incidence rate in the United States increased from about 220 cases per 100,000 adults to 350 cases per 100,000, after adjusting for age and sex. This equates to a 9.2% annual growth rate.
The researchers projected that if the growth rate did not increase after 2007, about 1.13 million AF cases would be newly diagnosed in 2010 (prevalence, 5.1 million) and 1.8 million cases would be newly diagnosed in 2030 (prevalence, 9.3 million), according to estimates from a dynamic age-period cohort simulation progression model. After applying a logarithmic growth rate, they estimated that AF incidence would reach 2.6 million cases and AF prevalence would reach 12.1 million cases in 2030.
“The projected increase of AF prevalence is not simply a result of increasing numbers of older people, but also reflects the empirical fact that the incidence rate of AF is increasing,” the researchers wrote.
Disclosure: The study was funded by Bristol-Myers Squibb and Pfizer. Five of the six researchers are employees of Bristol-Myers Squibb or Pfizer.
Perspective
Back to Top
Albert L. Waldo, MD
We know the incidence and prevalence of AF are increasing impressively, as this and several other similar studies have shown, but we do not really understand why. Part of the explanation is because people are living longer and methods of detecting AF have improved, but these explanations are hardly the whole answer. Moreover, the increasing incidence and prevalence of AF are a big problem for the well-being of the huge numbers of patients who get AF, the health care system and health care costs. In short, although the numbers from these several studies may be somewhat different, the impact is the same: the incidence and prevalence of AF are increasing and it is a very big public health problem.
In the end, this paper serves to remind us that there is still much work to do to understand why people get AF in the first place. Clearly, we have to understand AF far better before we can more effectively treat it or, better still, prevent it. Part of the problem is that not all AF is the same. There are many different pathways to AF, and probably more than one mechanism of AF. For instance, different patients can have different causes, obvious examples being AF after open-heart surgery, or associated with hyperthyroidism or a genetic predisposition, among many more examples. And, not only are we insufficiently informed about why there is high association of AF with hypertension, HF and other risk factors for developing AF, but we also still don’t understand the critical factors that make the atrial substrate so vulnerable to AF. Indeed, there is much work to be done.
Click Here to Manage Email Alerts