BMI affects young men’s risk of early atrial fibrillation and subsequent health outcomes after diagnosis

A recent analysis published in the Journal of the American Heart Association found that rising body mass index (BMI) in adolescent men is strongly associated with developing early atrial fibrillation, or an irregular heart rate, as well as with subsequent worse clinical outcomes after being diagnosed with atrial fibrillation.

The study included 1,704,467 young men (average age of 18.3 years) enrolled in compulsory military service in Sweden from 1969 through 2005. During a median follow-up of 32 years, 36,693 cases of atrial fibrillation were recorded, at an average age of 52.4 years at diagnosis. Compared with men with a baseline BMI of 18.5–<20.0 kg/m2, men with a BMI of 20.0–<22.5 kg/ m2 had a 1.06-times higher risk of developing atrial fibrillation and those with a BMI of 40.0–50.0 kg/ m2 had a 3.72-times higher risk.

In men diagnosed with atrial fibrillation who were followed for a median of approximately 6 years, investigators identified 3,767 deaths, 3,251 cases of heart failure, and 921 cases of ischemic stroke. Compared with those with a baseline BMI of <20 kg/ m2, those with a baseline BMI of >30 kg/ m2 had 2.86-times, 3.42-times, and 2.34-times higher risks of these outcomes, respectively.

“Whether screening for atrial fibrillation in early adulthood among individuals with long-standing obesity and more robust follow-up and initiation of anticoagulants in people with long-standing obesity and atrial fibrillation may improve survival needs to be addressed in future randomized trials,” said corresponding author Demir Djekic, MD, Ph.D., of Sahlgrenska University Hospital/Östra, in Sweden.