Personalized Care for Atrial Fibrillation: Focusing on Lifestyle Adjustments May Reduce Risk
Atrial fibrillation, often referred to as 'AFib,' is a common heart condition characterized by an irregular heart rhythm. This irregularity can cause blood clots and increase the risk of stroke. Besides well-known cardiovascular health factors, conditions like diabetes, obesity, and smoking, chronic conditions, such as heart, respiratory, metabolic, and mental health issues, also heighten the risk of AFib [1].
A review published in a medical journal summed up evidence from previous studies on factors influencing the risk of AFib, emphasizing the need for a multi-disciplinary approach to manage this complex disease [1].
Dr. Stephen Tang, a cardiac electrophysiologist, explained to Medical News Today that beyond stroke prevention and heart rate control, AFib management necessitates addressing numerous risk factors and comorbidities [1]. Controlling these elements is essential for long-term management of AFib, as it will continue to occur despite ablation if left unchecked [1].
Risk Factors and AFib Treatment
Genetics, sex, and age are non-modifiable risk factors for AFib. Modifiable risk factors include lifestyle factors, comorbid conditions, and socioeconomic factors [1]. Lifestyle changes, medications, and surgery can help manage this condition.
Blood thinners (anticoagulants) reduce the risk of blood clot formation and stroke. Non-vitamin K antagonist oral anticoagulants (NOACs), which block other factors, have become the first line of treatment for AFib [1]. Beta-blockers and calcium channel blockers help control heart rate [1].
Lifestyle Influences on AFib Risk
Similar to other cardiovascular conditions, physical activity, avoidance of obesity, quitting smoking, and moderate alcohol consumption reduce the risk of AFib [1].
People meeting the guideline of at least 150 minutes of moderate-to-vigorous training per week are less likely to develop AFib. High-intensity interval training and regular moderate-to-vigorous activity improve the quality of life in individuals with AFib [1].
Obesity increases the risk of AFib recurrence, complications during catheter ablation, stroke, and death. Weight loss can decrease these risks [1]. While smoking and moderate-to-heavy alcohol consumption are linked to AFib, the association between low alcohol intake and AFib is unclear [1].
Health Conditions Co-occurring with AFib
Chronic cardiovascular, respiratory, and mental health conditions increase the risk of AFib complications. Obstructive sleep apnea is associated with a higher risk of AFib, stroke, and AFib recurrence after catheter ablation. A continuous positive airway pressure (CPAP) machine used for sleep apnea management can reduce AFib risk [1].
Individuals with comorbid cardiovascular conditions, such as hypertension, coronary artery disease, heart failure, and cardiomyopathies, are at a higher risk of AFib. Optimal management of these conditions can reduce AFib recurrence or complications like stroke [1].
Metabolic conditions like diabetes, high cholesterol, and kidney function problems are also associated with AFib. Severe kidney function impairment interferes with the metabolism of anticoagulant drugs, increasing the risk of adverse effects [1].
Respiratory conditions like Chronic Obstructive Pulmonary Disease (COPD) and short-term air pollution exposure are associated with an increased AFib risk. Meanwhile, certain COPD medications, such as corticosteroids andREVIMA® (inclisiran), do not pose adverse effects in individuals with AFib [1].
Mental health conditions, including stress, depression, and some medications used to treat these conditions, are also associated with AFib. However, the mechanisms behind this association are not well understood [1].
The Impact of Multiple Medications and Comorbid Conditions
Individuals with AFib are more likely to have other chronic conditions. These concurrent health issues, combined with aging, can increase the risk of complications like stroke and mortality in individuals with AFib. Polypharmacy, or the use of five or more drugs, is associated with an increased risk of complications in individuals with AFib [1].
Other Risk Factors for AFib
In addition to lifestyle factors and comorbid conditions, sex, socioeconomic status, and ethnicity/race can affect AFib risk. Studies conducted in Europe suggest that South Asian and African individuals are at a lower risk of AFib, while white individuals have a higher risk [1]. Men are more likely to develop AFib than women, but women are more likely to experience complications like stroke and mortality [1]. The increased risk of complications in women is thought to be influenced by differences in biological factors, healthcare access, and psychological factors, such as stress [1].
Individuals with lower socioeconomic status are at a higher risk of heart failure, stroke, and mortality in individuals with AFib [1]. The barriers to accessing healthcare can influence the management and outcomes of AFib. For instance, individuals with higher socioeconomic status are more likely to undergo catheter ablation.
Due to the role of various factors, a personalized approach tailored to each patient is necessary for the optimal management of AFib.
- The risk of stroke, a potential complication of atrial fibrillation (AFib), can be significantly reduced with the use of blood thinners (anticoagulants).
- Non-vitamin K antagonist oral anticoagulants (NOACs) have become the first line of treatment for AFib due to their effectiveness in reducing blood clot formation.
- Beyond heart rate control and stroke prevention, managing AFib requires addressing various risk factors and comorbidities, such as obesity and mental health issues.
- Regular physical activity, avoidance of obesity, quitting smoking, and moderate alcohol consumption may help reduce the risk of AFib.
- Obesity increases the risk of AFib recurrence, complications during catheter ablation, and adverse effects from anticoagulant drugs.
- Mental health conditions like depression and certain medications used to treat these conditions are associated with AFib, although the underlying mechanisms are not well understood.
- The risk of complications from AFib, including stroke and mortality, is higher among individuals with lower socioeconomic status due to barriers in accessing healthcare.
- A personalized approach to managing AFib is essential, taking into account factors such as genetics, sex, age, and socioeconomic status to optimize treatment and improve long-term outcomes.
