Body mass index and the risk of new-onset atrial fibrillation in middle-aged adults

Anat Berkovitch, Shaye Kivity, Robert Klempfner, Shlomo Segev, Assi Milwidsky, Aharon Erez, Avi Sabbag, Ilan Goldenberg, Yechezkel Sidi, Elad Maor*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Background Increased body mass index (BMI) and obesity are associated with increased risk of new-onset atrial fibrillation (AF) among middle-aged adults. Objectives The objective of the study is to investigate the association between BMI and the risk for new-onset AF among middle-aged adults. Methods We investigated 18,290 men and women who were annually screened in a tertiary medical center. Participants were divided at baseline into 3 groups: normal weight (BMI ≥18 and <25 kg/m2, n = 7,692), overweight (BMI ≥25 and <30 kg/m2, n = 8,032), and obese (BMI ≥30 kg/m2, n = 2,566). The primary end point was new-onset AF during follow-up. Results Mean age of study population was 49 ± 11 years, and 73% were men. A total of 288 incident events (1.6%) occurred during 6 ± 4 years. Kaplan-Meier survival analysis showed that the cumulative probability of AF at 6 years was highest among obese participants, intermediate among overweight participants, and lowest among participants with normal weight (2.1%, 1.7%, and 0.8% respectively, P <.001). Multivariable Cox regression analysis showed that overweight and obesity were independently associated with increased AF risk (hazard ratio 1.54 P =.004 and 2.41 P <.001, respectively). Assessment of BMI change as a time-dependent covariate in the multivariable model showed that each 1 kg/m2 reduction in BMI during follow-up was associated with a significant 7% reduction in the risk for the occurrence of a first AF event (hazard ratio 0.93, 95% CI 0.88-0.99, P =.019). Consistently, similar analysis showed that each 5-kg weight loss during follow-up was independently associated with a significant 12% reduced risk of new-onset AF (95% CI 0.81-0.98, P =.02). Conclusions Our findings suggest that overweight and obesity are associated with increased AF risk, whereas weight reduction is independently associated with reduced risk of de novo AF.

Original languageEnglish
Pages (from-to)41-48
Number of pages8
JournalAmerican Heart Journal
StatePublished - 1 Mar 2016
Externally publishedYes


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