Low prevalence of atrial fibrillation in community-dwelling Chinese aged 55 years or older in Singapore: a population-based study

Background

The prevalence of atrial fibrillation (AF) in Asian populations appears to be lower than that in Western populations according to limited data. We conducted a community study to (a) estimate the prevalence of AF in Chinese adults aged 55 years or older in Singapore and (b) examine associated risk factors.

Methods

We conducted a whole-survey area population screening of 1839 Chinese residents aged 55 years or older in the southeast region of Singapore with a single electrocardiographic recording. We performed structured interviews and anthropometric as well as clinical measurements, including blood pressure.

Results

The estimated overall AF prevalence was 1.5% (95% confidence interval = 1.1-2.2); specifically, the prevalence was higher in men (2.6%) than in women (0.6%) and increased sharply to 5.8% only in individuals aged 80 years or older. This latter rate is lower than age-standardized rates in Western populations by approximately half and consistent with similarly low prevalence rates reported for Korea and China. Of the 26 cases of AF in this study, only 10 were known cases; 3 of the 10 patients were receiving anticoagulant therapy, whereas the rest were receiving antiplatelet therapy. Atrial fibrillation was significantly associated in multivariate analyses with male sex (odds ratio OR] = 4.10), heart failure (OR = 3.11), and stroke (OR = 3.60).

Conclusions

These data add support to the view that the prevalence of AF in Asian populations is lower than that in Western populations. The observations from these contrasting populations warrant attention in future studies.