Body Mass Index in Adolescence and Long‐Term Risk of Early Incident Atrial Fibrillation and Subsequent Mortality, Heart Failure, and Ischemic Stroke

Abstract

Background We sought to determine the role of obesity in adolescent men on development of atrial fibrillation (AF) and subsequent associated clinical outcomes in subjects diagnosed with AF. Methods and Results We conducted a nationwide, register‐based, cohort study of 1 704 467 men (mean age, 18.3±0.75 years) enrolled in compulsory military service in Sweden from 1969 through 2005. Height and weight, blood pressure, fitness, muscle strength, intelligence quotient, and medical disorders were recorded at baseline. Records obtained from the National Inpatient Registry and the Cause of Death Register were used to determine incidence and clinical outcomes of AF. During a median follow‐up of 32 years (interquartile range, 24–41 years), 36 693 cases (mean age at diagnosis, 52.4±10.6 years) of AF were recorded. The multivariable‐adjusted hazard ratio (HR) for AF increased from 1.06 (95% CI, 1.03–1.10) in individuals with body mass index (BMI) of 20.0 to 30 kg/m2 compared with those with BMI <20 kg/m2 were 2.86 (95% CI, 2.30–3.56), 3.42 (95% CI, 2.50–4.68), and 2.34 (95% CI, 1.52–3.61), respectively. Conclusions Increasing BMI in adolescent men is strongly associated with early AF, and with subsequent worse clinical outcomes in those diagnosed with AF with respect to all‐cause mortality, incident heart failure, and ischemic stroke.

Keywords

• adolescence and ischemic stroke
• atrial fibrillation
• body mass index
• heart failure
• mortality