Severe or morbid obesity in adolescents associated with higher risk of early atrial fibrillation

Severe or morbid obesity in adolescents associated with higher risk of early atrial fibrillation

Severe or morbid obesity at age 18 may be associated with an increased risk of atrial fibrillation in younger middle age. This is shown by a study from the University of Gothenburg, which contains data from around 1.7 million men in Sweden.

The study, published in the Journal of the American Heart Association, is based on analysis of nationwide registry data from 1,704,467 men who registered for military service in Sweden between 1969 and 2005. The average age at enrollment was 18 years.

Registration data included height, weight, blood pressure, fitness and muscle strength. Using inpatient care data and cause of death records, researchers were then able to determine the prevalence of atrial fibrillation and track its consequences.

Atrial fibrillation is characterized by an irregular and often rapid heartbeat, sometimes accompanied by the heart's inability to pump blood throughout the body as it should. Symptoms vary in severity and the disease can be chronic or consist of sporadic attacks. Hospitalization is often required and the risk of heart failure and ischemic stroke (cerebral infarction) increases.

Atrial fibrillation at the age of 43

Over a median follow-up period of 32 years, 36,693 cases of atrial fibrillation were recorded. For the entire group of participants, the average age at diagnosis was 52.4 years.

The increase in the risk of later atrial fibrillation among men who enlisted in the military began at what would typically be considered a low-normal weight and continued as body mass index (BMI) increased.

In men with severe or morbid obesity (BMI of 35 or higher) at enrollment, the risk of atrial fibrillation in younger middle age ranged from three to four times. The average age at diagnosis was 43.4 years.

BMI at enrollment was also strongly associated with mortality risk, regardless of cause, and with risk of heart failure and ischemic stroke.

According to the study, higher than normal BMI was strongly associated with early atrial fibrillation in adolescents, and their later clinical outcomes were relatively poor. Long-term exposure to overweight and obesity in individuals with atrial fibrillation was associated with an increased risk of death, heart failure, and ischemic stroke.

More active follow-up in the long term

The study's first author, Demir Djekic, conducts research in molecular and clinical medicine at the Sahlgrenska Academy at the University of Gothenburg and is also a specialist at Sahlgrenska University Hospital.

He sees screening for atrial fibrillation and more active follow-up and treatment as feasible in the long term if future studies can show better survival rates in people with obesity. At the same time, Djekic gives an indication of when it might be time to have his heart tested.

“If you have been overweight for a long time and are experiencing symptoms of atrial fibrillation, such as heart palpitations, shortness of breath or an irregular pulse, you can go to your health center and have an EKG done.”

Source:

University of Gothenburg

Reference:

Djekic, D., et al. (2022) Body mass index in adolescence and long-term risk of early-onset atrial fibrillation and subsequent mortality, heart failure and ischemic stroke. Journal of the American Heart Association. doi.org/10.1161/JAHA.121.025984.

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