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Body Mass Index in Adolescence and Long-Term Risk of Early Incident Atrial Fibrillation and Subsequent Mortality, Heart Failure, and Ischemic Stroke
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg Sweden; Cardiology unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg Sweden; Cardiology unit, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden.
Department of Internal Medicine Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Acute Medicine and Geriatrics (SU/Sahlgrenska), Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.
School of Public Health and Community, Medicine/Primary Health Care Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Region Västra Götaland Regionhälsan, Gothenburg, Sweden.
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2022 (English)In: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, E-ISSN 2047-9980, Vol. 11, no 21, article id e025984Article in journal (Refereed) Published
Abstract [en]

Background: We sought to determine the role of obesity in adolescent men on development of atrial fibrillation (AF) and subsequent associated clinical outcomes in subjects diagnosed with AF.

Methods and Results: We conducted a nationwide, register-based, cohort study of 1 704 467 men (mean age, 18.3±0.75 years) enrolled in compulsory military service in Sweden from 1969 through 2005. Height and weight, blood pressure, fitness, muscle strength, intelligence quotient, and medical disorders were recorded at baseline. Records obtained from the National Inpatient Registry and the Cause of Death Register were used to determine incidence and clinical outcomes of AF. During a median follow-up of 32 years (interquartile range, 24-41 years), 36 693 cases (mean age at diagnosis, 52.4±10.6 years) of AF were recorded. The multivariable-adjusted hazard ratio (HR) for AF increased from 1.06 (95% CI, 1.03-1.10) in individuals with body mass index (BMI) of 20.0 to <22.5 kg/m2 to 3.72 (95% CI, 2.44-5.66) among men with BMI of 40.0 to 50.0 kg/m2, compared with those with BMI of 18.5 to <20.0 kg/m2. During a median follow-up of ≈6 years in patients diagnosed with AF, we identified 3767 deaths, 3251 cases of incident heart failure, and 921 cases of ischemic stroke. The multivariable-adjusted HRs for all-cause mortality, incident heart failure, and ischemic stroke in AF-diagnosed men with baseline BMI >30 kg/m2 compared with those with BMI <20 kg/m2 were 2.86 (95% CI, 2.30-3.56), 3.42 (95% CI, 2.50-4.68), and 2.34 (95% CI, 1.52-3.61), respectively.

Conclusions: Increasing BMI in adolescent men is strongly associated with early AF, and with subsequent worse clinical outcomes in those diagnosed with AF with respect to all-cause mortality, incident heart failure, and ischemic stroke.

Place, publisher, year, edition, pages
John Wiley & Sons, 2022. Vol. 11, no 21, article id e025984
Keywords [en]
adolescence and ischemic stroke, atrial fibrillation, body mass index, heart failure, mortality
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:oru:diva-101851DOI: 10.1161/JAHA.121.025984ISI: 000877032700015PubMedID: 36260422Scopus ID: 2-s2.0-85141003596OAI: oai:DiVA.org:oru-101851DiVA, id: diva2:1704918
Funder
Swedish Heart Lung Foundation, 2018-0366Swedish Research Council, 2018-0366 2019-00193
Note

Funding agency:

Swedish state under an agreement concerning research and education of physicians ALFGBG-717211 

Available from: 2022-10-20 Created: 2022-10-20 Last updated: 2025-02-10Bibliographically approved

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