Secular trends in the prevalence of atrial fibrillation: The framingham study

An increasing prevalence of AF recently noted in hospital discharge data has not been verified in a population-based sample. We determined the prevalence of AF from 1968 to 1989 in the Framingham Study cohort aged 65 to 84 years. AF prevalence was evaluated by sex and in the presence of VHD, prior MI, and CHF. AF prevalence increased significantly in men overall, but not in women, and in men with and without VHD and MI, but not CHF. In men with prior MI, age-adjusted prevalence rose from 4.9% to 17.4% (p = 0.001). Multivariate analysis confirmed the increase in AF prevalence in men, when age, valve disease, and prior MI are taken into account. The basis for the increased AF prevalence in men is unexplained but may relate to recent improved MI survival. In an aging U.S. population this trend raises the concern of future increases in stroke incidence.