Severe obesity in young people is one of the key causes of artrial fibrillation in adult life, according to research from the University of Gothenburg.
A research team from the University of Gothenburg analysed data on over 1.7 million men in Sweden who signed up for military service between 1969-2005 to identify the causes of atrial fibrillation. The researchers found that severe or morbid obesity before the age of 18 is likely to lead to an elevated risk of atrial fibrillation in younger middle age.
The data included information on each man’s height, weight, blood pressure, fitness, and muscle strength. Data on inpatient care and cause-of-death records allowed the researchers to determine the prevalence of atrial fibrillation and track patient outcomes.
Atrial fibrillation is characterised by an irregular and sometimes rapid heartbeat, this can inhibit the heart’s ability to pump blood around the body as it should. Symptoms of atrial fibrillation vary in severity and the condition can be chronic. Patients are susceptible to sporadic attacks and hospitalisation is common. The disease increases the risk of heart failure and ischemic stroke (cerebral infarction) increase.
Identifying causes of atrial fibrillation
The researchers used a median follow-up period of 32 years, in this time 36,693 cases of atrial fibrillation were reported. The average age of diagnosis across the participants was 52.4 years old.
The rise in the risk of future atrial fibrillation began in those who signed up for military service at what is classified as low normal weight. The risk continued with rising body mass index (BMI).
In men with severe or morbid obesity (a BMI of 35 or higher) at the time of enrolment, the risk of atrial fibrillation in younger middle age was between three and four times higher than those with low normal body weight. The average age at diagnosis for these participants was 43.4 years old.
High BMI led to increased risk
BMI at the time of enrolment was also strongly associated with mortality risk irrespective of the cause of atrial fibrillation. High BMI was also strongly associated with a heightened risk of heart failure and ischemic stroke.
The researchers also found that higher-than-normal BMI in adolescents was strongly linked to early cases of atrial fibrillation. These participants’ subsequent clinical outcomes were relatively poor.
Long-term exposure to overweight and obesity among participants with atrial fibrillation was associated with increased rates of mortality, heart failure, and ischemic stroke.
The first author of the study, Demir Djekic, is involved in research in molecular and clinical medicine at Sahlgrenska Academy, University of Gothenburg, and is also a specialist physician at Sahlgrenska University Hospital.
Djekic believes that screening for atrial fibrillation, and more active follow-up and treatment, are feasible in the long-term options for healthcare systems. Djekic acknowledges that future studies will need to demonstrate better survival rates among individuals with obesity to validate these suggestions. Djekic has recommended when the best time for people to get their heart tested.
“If you’ve been overweight for a long time and are getting symptoms of atrial fibrillation, such as palpitations, shortness of breath, or an irregular pulse, you can go to your health centre and have an EKG done,” he said.
