A systematic evaluation of the available evidence suggests similarities as well as important differences in the risk factors for incidence of AF as compared with other cardiovascular diseases , which has implication s for the primary prevention strategies for atrial fibrillation
Established primary prevention strategies of cardiovascular diseases are based on underst and ing of risk factors , but whether the same risk factors are associated with  atrial fibrillation ( AF )  remains unclear .
Atrial fibrillation incidence and risk factors in relation to race-ethnicity and the population attributable fraction of atrial fibrillation risk factors: the Multi-Ethnic Study of Atherosclerosis.
PURPOSE We studied incident atrial fibrillation ( AF ) in the prospect i ve community-based Multi-Ethnic Study of Atherosclerosis ( MESA ) . Reportedly , non-Hispanic blacks ( NHBs ) have a lower AF burden compared with their non-Hispanic white ( NHW ) counterparts . Information on the epidemiology of AF in Hispanic and Asian population s is much more limited . METHODS We excluded participants with a history of AF at enrollment . A total of 6721 MESA participants were monitored for the first AF event ascertained according to hospital discharge International Classification of Diseases , Ninth Revision , codes . Age- and sex-adjusted incidence rates ( IRs ) of AF were calculated per 1000 person-years of observation . IR ratios were calculated using NHWs as the reference group . Age- and sex-adjusted population attributable fractions ( PAFs ) of established modifiable AF risk factors were ascertained . RESULTS In the MESA cohort , 47.2 % was male ; at baseline , 25.7 % had hypertension ; 12.5 % had diabetes . Three hundred five incident hospitalized AF events occurred over a mean follow-up of 7.3 years . Age- and sex-adjusted IRs and IR ratios showed that overall AF incidence was significantly lower among Hispanics , NHBs and Chinese compared with NHWs ( all P < .001 ) . Among participants 65 years of age or greater , Hispanics , Chinese , and blacks had significantly lower AF incidence than NHWs ( all P ≤ .01 ) , but IRs were similar among participants under age 65 years . The PAF for smoking was 27 % among NHBs but lower among other race-ethnic groups . Among NHWs , the PAF for hypertension was 22.2 % , but this was higher among NHBs ( 33.1 % ) , Chinese ( 46.3 % ) , and Hispanics ( 43.9 % ) . CONCLUSIONS Overall , the incidence of hospitalized AF was significantly lower in Hispanics , NHBs , and Chinese than in NHWs . A larger proportion of AF events appear to be attributable to hypertension among nonwhite population s compared with NHWs
A systematic evaluation of the available evidence suggests similarities as well as important differences in the risk factors for incidence of AF as compared with other cardiovascular diseases , which has implication s for the primary prevention strategies for atrial fibrillation
Established primary prevention strategies of cardiovascular diseases are based on underst and ing of risk factors , but whether the same risk factors are associated with  atrial fibrillation ( AF )  remains unclear .