Higher neuroticism level tied to incident AF, younger age at AF onset
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Key takeaways:
- People with a high neuroticism score were more likely to develop atrial fibrillation vs. those with a low score.
- Among those who developed AF, those with a high neuroticism score were diagnosed at a younger age.
People with a high level of neuroticism were more likely to develop atrial fibrillation, and to do so at a younger age, compared with people with lower levels, according to a study presented at Heart Rhythm 2023.
The researchers analyzed 394,834 participants from the UK Biobank (mean age, 56 years; 46% men) for whom a neuroticism score was calculated based on a self-questionnaire of 12 neurotic behavior domains. The cohort was assessed for 10-year risk for AF.
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“Among the AF patients we confront, some seemed to be more worrisome or depressed than others,” JungMin Choi, MD, from Seoul National University Hospital, South Korea, told Healio. “We wanted to evaluate whether such personality traits would affect the disease occurrence and if there were any genetic associations. The previous studies have focused on specific stressful conditions (eg, job strain) or negative emotions (eg, depression) and not personality traits. Thus, we designed this study to assess the association between neuroticism and AF.”
At 10 years, 6% of participants were diagnosed with AF.
After adjustment for confounders, including demographic factors, socioeconomic factors, lifestyle factors and comorbidities, increasing neuroticism score was associated with increased odds of incident AF (adjusted HR per 1 standard deviation increase = 1.05; 95% CI, 1.02-1.09; P = .005).
Women were more likely than men to have a high neuroticism score, and people aged 57 years or older were more likely than people younger than 57 years to have a lower neuroticism score, according to the researchers.
Among those who were diagnosed with AF, those with the highest neuroticism scores were diagnosed at a younger age (66.1 years) than those with the lowest scores (69.2 years), Choi and colleagues found.
In a Mendelian randomization analysis, there was a causal relationship between increase in neuroticism score and elevated risk for AF (OR by inverse variance weighted method = 1.06; 95% CI, 1.02-1.11; P = .007; OR by weighted-median method = 1.06; 95% CI, 1.01-1.11; P = .023).
“Our study focused on showing genetic causality between neuroticism and atrial fibrillation and could not prove the exact mechanism between the genes related to neuroticism and AF. But we came up with a possible hypothesis that could link neuroticism and AF,” Choi told Healio. “Firstly, systemic inflammation is regarded as one of the possible mechanisms of AF occurrence. Also, inflammation is upregulated in high-level neuroticism. Thus, such an increased level of inflammation in the high-level neuroticism may be the link between neuroticism and AF. Another possible mechanism is that the autonomic nervous system imbalance shown in neuroticism may have worked as a trigger for AF.”
As a result of the findings, “We believe an early active intervention would benefit people with high levels of neuroticism,” Choi told Healio. “An early intervention would include lifestyle modification such as alcohol and smoking cessation. Also, mental health management that reduces stress levels may be helpful.”
Editor's Note: This article was modified on June 5, 2023 to reflect updates to the data.
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Choi JM, et al. Abstract CE-452780-4. Presented at: Heart Rhythm 2023; May 19-21, 2023; New Orleans (hybrid meeting).
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