But what if only a relatively small percentage of AF patients are actually receiving treatment?
University of California San Francisco (UCSF) researchers suggested that three times more U.S. adults have the condition than previously thought. The first national estimate in 2 decades determined that 10.5 million Americans have AF—a dangerous but highly treatable arrhythmia.
That is nearly 5% of the population, according to the report in the Journal of the American College of Cardiology.
“Atrial fibrillation doubles the risk of mortality, is one of the most common causes of stroke, increases risks of heart failure, myocardial infarction, chronic kidney disease and dementia, and results in lower quality of life,” first author Jean Jacques Noubiap, MD, PhD, a postdoctoral scholar at UCSF with a specialty in global cardiovascular health, said in a press release. “Fortunately, atrial fibrillation is preventable, and early detection and appropriate treatment can substantially reduce its adverse outcomes.”
The authors pointed out that prevalence estimates of AF from large populations have not been updated for more than 2 decades. Using data from 1996 to 1997, a previous study projected that there would be 3.3 million adults with AF in the United States in 2020.
Because of the lag in estimate updates, the UCSF researchers sought to determine the contemporary age-, sex-, and race-standardized prevalence and the number of adults with diagnosed AF in the U.S.
To do that, they merged California’s state-wide healthcare databases to assemble a cohort of adults aged 20 years or older who received hospital-based care in California from 2005 to 2019. International Classification of Diseases codes were used to identify AF and other comorbidities, while the U.S. Census was used to calculate the national age-, sex-, and race-standardized estimates of diagnosed AF.
The results indicated that of approximately 29.3 million patients (mean age 50.6 ± 19.8 years, 53.8% women, 50.1% white), about 2 million (6.8%) had an AF diagnosis.
“The proportion of patients with diagnosed AF increased from 4.49% in 2005 to 2009 to 6.82% in 2015 to 2019,” the study team explained. “Over time, AF patients became relatively younger, were less likely to be female or white, and were more likely to have hypertension and diabetes.”
The study pointed out that by standardizing based on age-, sex-, race-, and ethnicity-based proportions to the U.S. population, it estimated that the current national prevalence of diagnosed AF is at least 10.55 million (95% CI, 10.48-10.62 million), making up 4.48% (95% CI, 4.47%-4.49%) of the adult population.
“The prevalence of diagnosed AF in the United States is higher than previously estimated. More efficient prevention and treatment strategies are needed to curb the burden of AF in the United States,” the authors concluded.
“Physicians recognize that atrial fibrillation is often encountered in essentially every field of practice,” said senior and corresponding author Gregory M. Marcus, MD, MAS, a cardiologist and electrophysiologist at UCSF Health. “These data provide objective evidence to demonstrate that prior projections severely underestimated how common it truly is.”
Dr. Marcus suggested that digital technologies might find that AF is even more common than the current analysis indicated.
“With the growing use of consumer wearables designed to detect atrial fibrillation combined with safer and more effective means to treat it, this current prevalence of atrial fibrillation in health care settings may soon be dwarfed by future healthcare utilization that will occur due to the disease,” Dr. Marcus explained.
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