Clinical InvestigationElectrophysiologyAtrial fibrillation and obesity—results of a meta-analysis
Section snippets
Search strategy
Comprehensive searches of the MEDLINE and Cochrane databases were performed using Web-based search engines for human studies published in English between 1966 and May 2007. Search terms included obesity, overweight, body mass index, arrhythmia, atrial fibrillation, and their combinations. We checked the reference lists of reviewed articles, prior meta-analyses, and original studies identified by the search to find other potentially relevant studies.
Study selection
Studies were included in the analysis if they
Study selection
Of the 468 identified articles from the search, 16 studies that enrolled a total of 123 249 individuals met the inclusion criteria and were included in the analysis. The rest of the studies did not meet our inclusion criteria because they either did not provide any data regarding the link between BMI categories and incidence of AF or did not provide clear BMI cutoffs for their BMI categories. These 16 articles consisted of 5 population-based cohort studies24, 25, 26, 27, 28 that enrolled 78 602
Discussion
Our meta-analysis of the available data shows that the presence of overweight and obesity increases the risk of AF in the general population. This relationship was strengthened by the finding of a classification-dependent relationship between BMI and the risk of developing AF. Furthermore, these findings were consistent for both men and women.
The electrophysiologic mechanisms by which obesity may lead to AF remain to be elucidated. Traditionally, obesity is thought to be an indirect cause of
References (48)
Obesity cardiomyopathy; pathophysiology and evolution of the clinical syndrome
Am J Med Sci
(2001)- et al.
Left atrial size in hypertensive men: influence of obesity, race, and age
J Am Coll Cardiol
(1997) - et al.
The relation of coronary artery disease, stroke, and mortality to weight in youth and in middle age
Lancet
(1983) - et al.
Epidemiology and natural history of atrial fibrillation: clinical implications
J Am Coll Cardiol
(2001) - et al.
Overweight and obesity as risk factors for atrial fibrillation or flutter: the Danish diet, cancer, and health study
Am J Med
(2005) - et al.
Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation
J Am Coll Cardiol
(2007) - et al.
Impact of body mass index and albumin on morbidity and mortality after cardiac surgery
J Thorac Cardiovasc Surg
(1999) - et al.
Effect of body mass index on early outcomes in patients undergoing coronary artery bypass surgery
J Am Coll Cardiol
(2003) - et al.
Effects of obesity and small body size on operative and long-term outcomes of coronary artery bypass surgery: a propensity-matched analysis
Ann Thorac Surg
(2005) - et al.
Effect of obesity on early morbidity and mortality following cardiac surgery
Heart Lung Circ
(2007)
Obesity in hypertension: how innocent a bystander?
Am J Med
Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight
J Am Coll Cardiol
The associations of body size and body composition with left ventricular mass: impacts for indexation in adults
J Am Coll Cardiol
Postoperative atrial fibrillation: a billion-dollar problem
J Am Coll Cardiol
Weight and blood pressure. Finding in hypertension screening of 1 million Americans
J Am Med Assoc
The relationship between body weight and blood pressure
J Hum Hypertens
Cardiopathy of obesity—a not-so-Victorian disease
N Eng J Med
Obesity as an independent risk factor for cardiovascular disease: a 26-year follow up of participants in the Framingham Heart Study
Circulation
Overweight and obesity as determinants of cardiovascular risk: the Framingham experience
Arch Intern Med
Adiposity of the heart, revisited
Ann Intern Med
Prevalence of obesity and diabetes, and obesity-related health risk factors, 2001
J Am Med Assoc
Obesity and the risk of heart failure
N Eng J Med
Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss
Arterioscler Thromb Vasc Biol
Body mass index and thromboembolic stroke in nonsmoking men in older middle age, The Honolulu Heart Program
Stroke
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Dr Messerli served as an ad hoc consultant/speaker for the following organizations: Abbott, GSK, Novartis, Pfizer, AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Forest, Sankyo, and Sanofi. Dr Somers is supported by grants HL 73211, HL 65176, and MO1-RR00585 from the National institutes of Health (Bethesda, MD). He serves as a consultant for Respironics, Cardiac Concepts, ResMed, and Sepracor.
This work was presented in part at the 2007 Annual Scientific Session of the American College of Cardiology, New Orleans, LA.