Race/Ethnicity Is An Independent Predictor Of Atrial Fibrillation Among Individuals 60 Years And Older

Atrial fibrillation (AF) is present in 4 – 8% of people 60 years and older based on studies of predominantly white populations. Limited data involving specific disease states (e.g., HF and acute coronary syndromes) suggest that AF prevalence in blacks and Asians are approximately half that of whites. Scarce data exist regarding racial/ethnic differences in AF prevalence in US communities. This is a cross-section, observational study. In 2005, there were 467,087 members in the Kaiser Permanente Southern California health plan aged 60 years or older. By searching ICD-9 codes and electronic ECG archives, we identified all members in this age group with AF. Patients with pulmonary embolism, thyroid, pericardial, rheumatic, other valvular diseases and early post-cardiac surgery AF cases were excluded. Race/ethnicity data was assigned administratively using hospital-based service utilization, surname, and geocoding methods and was available for 74.1% of members (73% of non-AF and 89.8% of AF), 99% of which belonged to one of the following 4 groups: white, black, Asian, and Hispanic. The independent effect of race/ethnicity on AF was analyzed with logistic regression methods adjusting for potential confounders (search period 2003–5): age, gender, duration of membership, education attainment, household income, prior stroke, diabetes, hypertension, heart failure, chronic kidney disease, coronary artery disease, COPD, morbid obesity and sleep apnea. Among members aged 60 years and older, selected prevalent AF risk factors are listed in the table . The overall AF prevalence was 6.8%. Among members whose race/ethnicity was known, AF was most prevalent in whites. The odds ratios of having AF among nonwhites were substantially lower than whites in our crude and adjusted logistic regression models. White race/ethnicity is associated with a greater risk for AF after adjusting for comorbidities associated with the development of AF.