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Advisory Committee Chair

Virginia J Howard

Advisory Committee Members

Emily Levitan

Byron C Jaeger

Document Type

Thesis

Date of Award

2021

Degree Name by School

Master of Science in Public Health (MSPH) School of Public Health

Abstract

Background: Our knowledge of the association between abdominal obesity (AO) and the risk of atrial fibrillation (AF) after adjusting for body mass index (BMI) is limited. Methods: We included 11,617 black and white participants (mean age 63.0 + 8.4 years) from the REGARDS (REasons for Geographic and Racial Differences in Stroke) national cohort study who were free of AF at baseline between 2003 and 2007, and completed a follow-up exam between 2013 and 2016 with assessment of AF. A multivariable logistic regression model was used to estimate the odds ratio (OR) with 95% confidence interval of incident AF associated with AO. We also evaluated the association between waist circumference and incident AF. Results: Over a median follow-up of 9.4 years, 999 participants developed AF. AO was associated with an increased risk of AF in a multivariable model adjusted for socio-demographic, lifestyle and cardiovascular risk factors (OR 1.43, 95% CI 1.24-1.65, p<0.001). The association was attenuated after adjusting for BMI (OR 1.13, 95% CI 0.95-1.35, p=0.16). There was no evidence of interaction between AO and incident AF by age category (age > 65 vs. age ≤ 65), sex, race, obesity or BMI category. Conversely, a 10 cm increase in waist circumference (WC) was associated with a higher incidence of AF after controlling for BMI (OR 1.18 95% CI 1.09-1.29, p<0.001), in both non-obese (OR 1.14, 95% CI 1.031.28, p=0.02) and obese (OR 1.26, 95% CI 1.11-1.42, p<0.001) people. i Conclusions: There was an association between AO and incident AF, but the association was weakened after adjusting for BMI. There was a significant association between WC and incident AF, after taking other AF risk factors and BMI into account. WC is a potential modifiable risk factor for AF, and further research is warranted to explore the effect of decreasing WC on the population AF burden.

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