Daily Dose: Worldwide Burden of Atrial Fibrillation Doubled Over 30 Years

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

On August 25, 2023, we reported on a study published in the Journal of the American Heart Association that aimed to understand the distribution and disparities of the global burden of distribution and disparities of the global burden of atrial fibrillation (AF) and atrial flutter (AFL) as well as the underlying risk factors.

The study

Researchers analyzed data on AF/AFL burden for the years 1990 to 2019 from the Global Burden of Disease data set. Countries were grouped into low, lower-middle, upper-middle, and high national income classess according to World Bank categories. The underlying data were collected by more than 9000 researchers in 160 countries.

The findings

• The absolute number of AF/AFL cases more than doubled from 1990 to 2019, from 28 273 978, to 56 671 814.

• The increase in prevalence has been greatest in middle-income countries, with an increase of 146.6% in lower-middle income countries and 145.2% in upper middle-income countries.

• In low-income countries, the prevalence rose 120.7%.

• In high-income countries, the prevalence rose by 67.8%; these countries had the highest absolute prevalence until 2014, investigators reported, but then saw a leveling-off, and cases rose more quickly in middle-income countries.

• High-income countries still have the highest number of cases across the population, with 1738 per 100 000 population, more than double the 844 per 100 000 in upper middle-income countries.

Authors' commentary

"The global burden of AF/AFL is increasing in all income groups and is more pronounced in middle‐income countries, with further growth to be expected. Underdiagnosis of AF/AFL in low‐ and middle‐income countries may contribute to lower reported prevalence. The risk factor distribution varies between income groups."

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