Personalized Care Focusing on Lifestyle Factors May Reduce Risk of Atrial Fibrillation
Atrial fibrillation, a common type of irregular heartbeat, affects over people globally. This condition, a significant risk factor for stroke, is influenced by a variety of factors.
Beyond well-known cardiovascular health factors like physical activity, diabetes, obesity, and smoking, the presence of chronic conditions, such as cardiovascular, respiratory, metabolic, and mental health issues, can heighten the risk of atrial fibrillation.
A recent review published in a major journal gathered data from earlier studies on lifestyle factors, comorbid conditions, and socioeconomic factors that might influence the risk of atrial fibrillation. The review underscored the importance of multidisciplinary, personalized care for managing atrial fibrillation and minimizing the risk of death and the development of other health issues.
Dr. Stephen Tang, a cardiac electrophysiologist, explained to Medical News Today: "Managing atrial fibrillation isn't just about taking oral anticoagulants for stroke prevention or controlling the heart rate with medication or ablation. This complex disease is driven by numerous risk factors and comorbidities."
According to Dr. Tang, identifying and optimizing these risk factors is essential for long-term management and control of atrial fibrillation.
Risk Factors and Treatment for Atrial Fibrillation
Atrial fibrillation, often abbreviated as "AFib," is an irregular heart rhythm caused by the abnormal beating of the left upper heart chamber or atrium. This irregular rhythm can lead to the formation of blood clots in the atrium, which can travel to the brain and cause a stroke.
Nonmodifiable risk factors for atrial fibrillation include genetic factors, sex, and age. Other risk factors include lifestyle factors, comorbid conditions, and socioeconomic factors.
Blood thinners (anticoagulants) can help reduce the risk of blood clot formation and stroke. More recently, nonvitamin K antagonist oral anticoagulants (NOACs) have become the first-line treatment for atrial fibrillation. Other drugs, like beta-blockers and calcium channel blockers, can help control the heart rate. When lifestyle modifications and medications are insufficient, invasive procedures like catheter ablation may be necessary to restore a normal heart rhythm.
Lifestyle Factors Influencing AFib Risk
Similar to other cardiovascular conditions, lifestyle factors such as physical activity levels, obesity, smoking, and excessive alcohol consumption heighten the risk of atrial fibrillation.
Regular physical activity and high-intensity interval training are beneficial for reducing atrial fibrillation morbidity and improving quality of life. Although studies suggest individuals with atrial fibrillation who engage in moderate-to-vigorous physical activity are at reduced risk of heart failure and cardiovascular-associated mortality, evidence supporting the role of physical activity in preventing stroke is scant.
Obesity is a prominent risk factor for atrial fibrillation and can increase the likelihood of recurrence, complications during catheter ablation, stroke, and death. Weight loss can help reduce the risk of atrial fibrillation recurrence and complications.
Smoking and moderate-to-heavy alcohol consumption are risk factors for atrial fibrillation. While moderate-to-heavy alcohol consumption is associated with atrial fibrillation risk, the relationship between low levels of alcohol intake and atrial fibrillation is unclear.
Health Conditions That Co-occur with AFib
Chronic cardiovascular, respiratory, and mental health conditions not only increase the risk of atrial fibrillation but can also exacerbate complications associated with this condition.
Obstructive sleep apnea, a condition estimated to occur in 21-74% of atrial fibrillation patients, can increase the risk of blood clot formation and alter the structural and electrical properties of the heart. The use of a continuous positive airway pressure (CPAP) machine for sleep apnea management can help reduce the risk of atrial fibrillation incidence, recurrence, or progression.
Individuals with pre-existing cardiovascular conditions, such as coronary artery disease, hypertension, heart failure, and cardiomyopathies, are at an increased risk of atrial fibrillation. Effective management and treatment of these comorbid cardiovascular conditions can help reduce the risk of atrial fibrillation recurrence or complications like stroke.
In addition to cardiovascular conditions, diabetes is associated with an increased risk of atrial fibrillation and complications. While high total cholesterol and low-density lipoprotein levels are risk factors for cardiovascular diseases, they are associated with a lower risk of atrial fibrillation. In contrast, higher levels of triglycerides are associated with an increased risk of atrial fibrillation.
Impact of Comorbid Conditions and Multiple Medication Use
Individuals with atrial fibrillation are more likely to have other comorbid conditions, which can increase the risk of complications such as stroke and mortality. The presence of concurrent chronic conditions necessitates the use of multiple medications, raising the risk of adverse effects.
The use of five or more drugs, known as "polypharmacy," is associated with the potential for drug-drug interactions and adverse events. Nonvitamin K antagonist oral anticoagulants are associated with fewer adverse events than warfarin in atrial fibrillation patients and can be used with caution.
Other Risk Factors for AFib
In addition to lifestyle factors and comorbid conditions, sex, socioeconomic status, and ethnicity/race can influence the risk of atrial fibrillation. Studies conducted in Europe suggest that individuals of South Asian and African origin are at a lower risk of atrial fibrillation than the white population, whereas data from the United States indicates that white individuals are at a higher risk. In terms of sex, atrial fibrillation is more prevalent in men but women are at a higher risk of complications, including stroke and mortality.
Acknowledging the importance of addressing these risk factors, Dr. Nikhil Warrier, a cardiac electrophysiologist, noted, "The underlying risk factors that increase the likelihood of poor AF-related outcomes can be different for every patient." A personalized, multidisciplinary approach is crucial for effective atrial fibrillation management.
- Atrial fibrillation, influenced by a variety of factors, is a common type of irregular heartbeat that affects over people globally and is a significant risk factor for stroke.
- Managing atrial fibrillation isn't just about taking oral anticoagulants for stroke prevention or controlling the heart rate with medication or ablation; this complex disease is driven by numerous risk factors and comorbidities.
- Identifying and optimizing these risk factors is essential for long-term management and control of atrial fibrillation, as they include lifestyle factors, chronic conditions, and socioeconomic factors.
- Similar to other cardiovascular conditions, lifestyle factors such as physical activity levels, obesity, smoking, and excessive alcohol consumption heighten the risk of atrial fibrillation.
- Chronic cardiovascular, respiratory, and mental health conditions not only increase the risk of atrial fibrillation but can also exacerbate complications associated with this condition.
- Individuals with atrial fibrillation are more likely to have other comorbid conditions, which can increase the risk of complications such as stroke and mortality, and necessitate the use of multiple medications.
- The use of five or more drugs, known as "polypharmacy," is associated with the potential for drug-drug interactions and adverse events.
- Sex, socioeconomic status, and ethnicity/race can influence the risk of atrial fibrillation, with South Asian and African origin populations possibly having a lower risk, and men more prevalent in atrial fibrillation but women at a higher risk of complications. A personalized, multidisciplinary approach is crucial for effective atrial fibrillation management.
