Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study
Aims - To use the parametric g-formula to estimate the long-term risk of atrial fibrillation (AF) by sex and education under hypothetical interventions on six modifiable risk factors. Methods and results - We estimated the risk reduction under hypothetical risk reduction strategies for smoking, phys...
Published in: | European Journal of Preventive Cardiology |
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2023
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Online Access: | https://hdl.handle.net/10037/32492 https://doi.org/10.1093/eurjpc/zwad240 |
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ftunivtroemsoe:oai:munin.uit.no:10037/32492 2024-02-11T10:09:11+01:00 Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study Nilsen, Linn Sharashova, Ekaterina Løchen, Maja-Lisa Danaei, Goodarz Wilsgaard, Tom 2023-07-19 https://hdl.handle.net/10037/32492 https://doi.org/10.1093/eurjpc/zwad240 eng eng Oxford University Press European Journal of Preventive Cardiology (EJPC) Nilsen, Sharashova, Løchen, Danaei, Wilsgaard. Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study. European Journal of Preventive Cardiology (EJPC). 2023;30(16):1791-1800 FRIDAID 2212220 doi:10.1093/eurjpc/zwad240 2047-4873 2047-4881 https://hdl.handle.net/10037/32492 Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Copyright 2023 The Author(s) https://creativecommons.org/licenses/by-nc/4.0 Journal article Tidsskriftartikkel Peer reviewed publishedVersion 2023 ftunivtroemsoe https://doi.org/10.1093/eurjpc/zwad240 2024-01-18T00:08:05Z Aims - To use the parametric g-formula to estimate the long-term risk of atrial fibrillation (AF) by sex and education under hypothetical interventions on six modifiable risk factors. Methods and results - We estimated the risk reduction under hypothetical risk reduction strategies for smoking, physical activity, alcohol intake, body mass index, systolic, and diastolic blood pressure in 14 923 women and men (baseline mean age 45.8 years in women and 47.8 years in men) from the population-based Tromsø Study with a maximum of 22 years of follow-up (1994–2016). The estimated risk of AF under no intervention was 6.15% in women and 13.0% in men. This cumulative risk was reduced by 41% (95% confidence interval 17%, 61%) in women and 14% (−7%, 30%) in men under joint interventions on all risk factors. The most effective intervention was lowering body mass index to ≤ 25 kg/m2, leading to a 16% (4%, 25%) lower risk in women and a 14% (6%, 23%) lower risk in men. We found significant sex-differences in the relative risk reduction by sufficient physical activity, leading to a 7% (-4%, 18%) lower risk in women and an 8% (−2%, −13%) increased risk in men. We found no association between the level of education and differences in risk reduction by any of the interventions. Conclusion - The population burden of AF could be reduced by modifying lifestyle risk factors. Namely, these modifications could have prevented 41% of AF cases in women and 14% of AF cases in men in the municipality of Tromsø, Norway during a maximum 22-year follow-up period. Article in Journal/Newspaper Tromsø University of Tromsø: Munin Open Research Archive Norway Tromsø European Journal of Preventive Cardiology 30 16 1791 1800 |
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Open Polar |
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University of Tromsø: Munin Open Research Archive |
op_collection_id |
ftunivtroemsoe |
language |
English |
description |
Aims - To use the parametric g-formula to estimate the long-term risk of atrial fibrillation (AF) by sex and education under hypothetical interventions on six modifiable risk factors. Methods and results - We estimated the risk reduction under hypothetical risk reduction strategies for smoking, physical activity, alcohol intake, body mass index, systolic, and diastolic blood pressure in 14 923 women and men (baseline mean age 45.8 years in women and 47.8 years in men) from the population-based Tromsø Study with a maximum of 22 years of follow-up (1994–2016). The estimated risk of AF under no intervention was 6.15% in women and 13.0% in men. This cumulative risk was reduced by 41% (95% confidence interval 17%, 61%) in women and 14% (−7%, 30%) in men under joint interventions on all risk factors. The most effective intervention was lowering body mass index to ≤ 25 kg/m2, leading to a 16% (4%, 25%) lower risk in women and a 14% (6%, 23%) lower risk in men. We found significant sex-differences in the relative risk reduction by sufficient physical activity, leading to a 7% (-4%, 18%) lower risk in women and an 8% (−2%, −13%) increased risk in men. We found no association between the level of education and differences in risk reduction by any of the interventions. Conclusion - The population burden of AF could be reduced by modifying lifestyle risk factors. Namely, these modifications could have prevented 41% of AF cases in women and 14% of AF cases in men in the municipality of Tromsø, Norway during a maximum 22-year follow-up period. |
format |
Article in Journal/Newspaper |
author |
Nilsen, Linn Sharashova, Ekaterina Løchen, Maja-Lisa Danaei, Goodarz Wilsgaard, Tom |
spellingShingle |
Nilsen, Linn Sharashova, Ekaterina Løchen, Maja-Lisa Danaei, Goodarz Wilsgaard, Tom Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study |
author_facet |
Nilsen, Linn Sharashova, Ekaterina Løchen, Maja-Lisa Danaei, Goodarz Wilsgaard, Tom |
author_sort |
Nilsen, Linn |
title |
Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study |
title_short |
Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study |
title_full |
Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study |
title_fullStr |
Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study |
title_full_unstemmed |
Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study |
title_sort |
hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the tromsø study |
publisher |
Oxford University Press |
publishDate |
2023 |
url |
https://hdl.handle.net/10037/32492 https://doi.org/10.1093/eurjpc/zwad240 |
geographic |
Norway Tromsø |
geographic_facet |
Norway Tromsø |
genre |
Tromsø |
genre_facet |
Tromsø |
op_relation |
European Journal of Preventive Cardiology (EJPC) Nilsen, Sharashova, Løchen, Danaei, Wilsgaard. Hypothetical interventions and risk of atrial fibrillation by sex and education: application of the parametric g-formula in the Tromsø Study. European Journal of Preventive Cardiology (EJPC). 2023;30(16):1791-1800 FRIDAID 2212220 doi:10.1093/eurjpc/zwad240 2047-4873 2047-4881 https://hdl.handle.net/10037/32492 |
op_rights |
Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Copyright 2023 The Author(s) https://creativecommons.org/licenses/by-nc/4.0 |
op_doi |
https://doi.org/10.1093/eurjpc/zwad240 |
container_title |
European Journal of Preventive Cardiology |
container_volume |
30 |
container_issue |
16 |
container_start_page |
1791 |
op_container_end_page |
1800 |
_version_ |
1790608954566377472 |