4.4 Article

Prevalence of atrial fibrillation and association with clinical, sociocultural, and ancestral correlates among Hispanic/Latinos: The Hispanic Community Health Study/Study of Latinos

Journal

HEART RHYTHM
Volume 16, Issue 5, Pages 686-693

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.hrthm.2018.11.033

Keywords

Atrial fibrillation; Clinical correlates; Epidemiology; Hispanics; Latinos

Funding

  1. National Heart, Lung, and Blood Institute to the University of North Carolina [N01-HC65233]
  2. University of Miami [N01-HC65234]
  3. Albert Einstein College of Medicine [N01-HC65235]
  4. Northwestern University [N01-HC65236]
  5. San Diego State University [N01-HC65237]
  6. National Institutes of Health/National Heart, Lung, and Blood Institute [R01 HL104199, T32 HL125294]
  7. American Heart Association [16EIA26410001]

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BACKGROUND Hispanics/Latinos represent the largest ethnic minority group in the United States. Atrial fibrillation (AF) is the most common cardiac arrhythmia in the United States. OBJECTIVE The purpose of this study was to provide data on the prevalence of AF and its correlates in a representative Hispanic/Latino population-based sample inclusive of all background groups. METHODS Hispanic Community Health Study/Study of Latinos participants (n = 16,415; 60% women; 59% age >45 years) were enrolled between March 2008 and June 2011, representing individuals of Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American heritage. AF was defined by the 12-lead electrocardiogram and/or participant self-report of a physician diagnosis. Hispanic background-specific AF prevalence rates were determined. Weighted sequential logistic regression models were adjusted for demographic factors (age and sex) and clinical variables (diabetes, hypertension, body mass index, tobacco use, and estimated glomerular filtration rate). RESULTS The overall weighted prevalence of AF was 1.0% (n = 162), with the highest prevalence in Hispanics of Dominican and Puerto Rican backgrounds (1.9% and 2.5% respectively) and the lowest in those of Mexican background (0.3%). Diabetes, hypertension, renal disease, left ventricular hypertrophy determined by the electrocardiogram, alcohol use, and English language preference (greater acculturation) (P < .01 for all) were significantly associated with higher AF prevalence. Multivariate analysis by Hispanic/Latino background group showed that Hispanics of Dominican and Puerto Rican backgrounds were at a 3- to 6-fold higher risk of AF than their Mexican counterparts. CONCLUSION In a diverse representative population of Hispanics/Latinos, overall AF prevalence was low and varied significantly across Hispanic/Latino background groups independent of clinical or demographic factors.

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