Journal
CIRCULATION
Volume 126, Issue 19, Pages 2302-2308Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/CIRCULATIONAHA.112.112300
Keywords
atrial fibrillation; atrial premature complexes; cardiovascular diseases; epidemiology; risk factors
Funding
- Swiss National Science Foundation
- Federal Office for Forest, Environment and Landscape
- Federal Office of Public Health
- Federal Office of Roads and Transport
- canton's government of Aargau
- canton's government of Basel-Stadt
- canton's government of Basel-Land
- canton's government of Geneva
- canton's government of Luzern
- canton's government of Ticino
- canton's government of Zurich
- Swiss Lung League
- Lung League of Basel-Stadt/Basel-Landschaft
- Lung League of Geneva
- Lung League of Ticino
- Lung League of Zurich
- Swiss National Science Foundation [PP00P3_133681]
- Swiss National Science Foundation (SNF) [PP00P3_133681] Funding Source: Swiss National Science Foundation (SNF)
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Background-Premature atrial contractions (PACs) are independent predictors of atrial fibrillation, stroke, and death. However, little is known about PAC frequency in the general population and its association with other cardiovascular risk factors. Methods and Results-We performed a cross-sectional analysis among participants of the population-based Swiss cohort Study on Air Pollution and Lung Diseases in Adults (SAPALDIA). 24-hour Holter electrocardiograms to assess PAC prevalence and frequency were performed in a random sample of 1742 participants aged >= 50 years. The median (interquartile range) number of PACs per hour was 0.8 (0.4-1.8), 1.1 (0.5-2.4), 1.4 (0.7-4.6), 2.3 (0.8-6.9), and 2.6 (1.2-6.5) among participants aged 50 to 55, 55 to 60, 60 to 65, 65 to 70, and >= 70 years, respectively (P<0.0001). Only 18 (1.0%) participants did not have at least 1 PAC during Holter monitoring. In multivariable negative binomial regression models, PAC frequency was significantly associated with age (risk ratio [RR] per SD 1.80; P<0.0001), height (RR per SD 1.52; P<0.0001), prevalent cardiovascular disease (RR 2.40; P<0.0001), log-transformed N-terminal pro B-type natriuretic peptides (RR per SD 1.27; P<0.0001), physical activity >= 2 hours per day (RR 0.69; P=0.002), and high-density lipoprotein cholesterol (RR per SD 0.80; P=0.0002). Hypertension and body mass index were not significantly related to PAC frequency. Conclusions-To our knowledge, this is the first study to assess risk factors for PAC frequency in the general population aged >= 50 years. PACs are common, and their frequency is independently associated with age, height, history of cardiovascular disease, natriuretic peptide levels, physical activity, and high-density lipoprotein cholesterol. The underlying mechanisms of these relationships need to be addressed in future studies. (Circulation. 2012; 126: 2302-2308.)
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