Global epidemiology of atrial fibrillation

• Published in: Nature reviews cardiology Vol. 11; no. 11; pp. 639 - 654
• Main Authors: Rahman, Faisal, Kwan, Gene F., Benjamin, Emelia J.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.11.2014; Nature Publishing Group
• Subjects: 692/308/174; 692/699/75/29/1309; Atrial fibrillation; Atrial Fibrillation - complications; Atrial Fibrillation - epidemiology; Atrial Fibrillation - prevention & control; Cardiac Imaging; Cardiac Surgery; Cardiology; Cardiovascular research; Care and treatment; Cost of Illness; Distribution; Epidemiology; Global Health - statistics & numerical data; Humans; International aspects; Medicine & Public Health; Prevalence; review-article; Risk Factors; Stroke - epidemiology; Stroke - etiology
• ISSN: 1759-5002; 1759-5010
• DOI: 10.1038/nrcardio.2014.118

Key Points Atrial fibrillation (AF) is a worldwide epidemic affecting approximately 33 million people, and its rising prevalence is expected to account for increasing clinical and public health costs Australia, Europe, and the USA have the highest reported prevalence of AF (1% in the adult population), but the prevalence of AF in low-income and middle-income countries is probably underestimated AF is associated with an increased risk of myocardial infarction, heart failure, stroke, dementia, and chronic kidney disease, as well as increased mortality Treatment of patients with AF is inadequate: <50% of those at high thromboembolic risk receive anticoagulation therapy worldwide The dearth of data on the prevalence, lifetime risk, prognosis, prevention, treatment, and economic implications of AF in many regions around the world remains to be addressed The prevalence of atrial fibrillation (AF) is estimated to increase worldwide, mainly as a consequence of generalized population ageing. Even though the rise in AF prevalence is a global trend, data from Africa, Asia, and South America are limited and might underestimate the true frequency of AF. In this Review, the authors discuss the available epidemiological data on AF and highlight the widespread inadequacy of its treatment. Atrial fibrillation (AF) is a major public health burden worldwide, and its prevalence is set to increase owing to widespread population ageing, especially in rapidly developing countries such as Brazil, China, India, and Indonesia. Despite the availability of epidemiological data on the prevalence of AF in North America and Western Europe, corresponding data are limited in Africa, Asia, and South America. Moreover, other observations suggest that the prevalence of AF might be underestimated—not only in low-income and middle-income countries, but also in their high-income counterparts. Future studies are required to provide precise estimations of the global AF burden, identify important risk factors in various regions worldwide, and take into consideration regional and ethnic variations in AF. Furthermore, in response to the increasing prevalence of AF, additional resources will need to be allocated globally for prevention and treatment of AF and its associated complications. In this Review, we discuss the available data on the global prevalence, risk factors, management, financial costs, and clinical burden of AF, and highlight the current worldwide inadequacy of its treatment.