High neck circumference linked to elevated AF risk
High neck circumference was associated with risk for incident atrial fibrillation, according to an analysis published in the Journal of the American Heart Association.
“Obesity is typically measured using standard anthropometric measures such as BMI, waist circumference or waist-to-hip ratio,” Jelena Kornej, MD, MSc, associate faculty member at the Boston University School of Medicine and Public Health, and colleagues wrote. “Upper-body subcutaneous fat is a unique fat deposit, and its measurement can be approximated using neck circumference. Neck circumference has been shown to be associated with increased cardiovascular risk. There is evidence that free fatty acid release from upper-body subcutaneous fat is higher compared with lower-body subcutaneous fat.”
To understand the association between neck circumference and incident AF, researchers analyzed participants from the Framingham Heart Study Offspring, New Offspring Spouse, Third Generation, Omni 1 and Omni 2 cohorts with available neck circumference data (n = 4,093; mean age, 64 years; 55% women). Mean follow-up was 11 years. High neck circumference was defined at 14 inches or more for women and 17 inches or more for men.
The mean neck circumference was 13.7 inches for women and 16.1 inches for men.
During follow-up, the incidence of AF events was 10.8 per 1,000 person-years in participants with low neck circumference and 16.2 per 1,000 person-years among those with high neck circumference.
Incidence of death during follow-up was 14.2 per 1,000 person-years in participants with low neck circumference and 16.7 per 1,000 person-years among those with high neck circumference.
The risk for incident AF was greater among individuals with high neck circumference compared to those with lower neck circumference (subdistribution HR [sHR] = 1.58; 95% CI, 1.32-1.9; P < .0001), the researchers wrote.
The risk was slightly attenuated but remained significant after further adjustment for BMI (sHR = 1.51; 95% CI, 1.21-1.89; P = .0003), waist circumference (sHR = 1.47; 95% CI, 1.18-1.83; P < .0001) and height/weight (sHR = 1.37; 95% CI, 1.09-1.72; P = .007), the researchers wrote.
The relationship between neck circumference and AF risk was more prominent with ascending BMI (P for interaction = .04) but did not vary by age or sex, according to the researchers.
“Our findings indicate that neck circumference potentially may be used as an easily obtainable measure for assessing risk of incident AF,” the researchers wrote. “Further study is warranted to help understand the causal relation between upper-body subcutaneous fat and AF initiation, and also its role in primary and secondary prevention of AF.”
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