Abstract:
Background: The association between ideal cardiovascular health (ICVH) status and atrial fibrillation or flutter (AFF)
diagnosis has been less studied compared to other cardiovascular diseases.
Objective: To analyze the association between AFF diagnosis and ICVH metrics and scores in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
Methods: This study analyzed data from 13,141 participants with complete data. Electrocardiographic tracings were
coded according to the Minnesota Coding System, in a centralized reading center. ICVH metrics (diet, physical activity,
body mass index, smoking, blood pressure, fasting plasma glucose, and total cholesterol) and scores were calculated
as proposed by the American Heart Association. Crude and adjusted binary logistic regression models were built to
analyze the association of ICVH metrics and scores with AFF diagnosis. Significance level was set at 0.05.
Results: The sample had a median age of 55 years and 54.4% were women. In adjusted models, ICVH scores
were not significantly associated with prevalent AFF diagnosis (odds ratio [OR]:0.96; 95% confidence interval
[95% CI]:0.80-1.16; p=0.70). Ideal blood pressure (OR:0.33; 95% CI:0.15–0.74; p=0.007) and total cholesterol
(OR:1.88; 95% CI:1.19–2.98; p=0.007) profiles were significantly associated with AFF diagnosis.
Conclusions: No significant associations were identified between global ICVH scores and AFF diagnosis after multivariable
adjustment in our analyses, at least partially due to the antagonistic associations of AFF with blood pressure and total
cholesterol ICVH metrics. Our results suggest that estimating the prevention of AFF burden using global ICVH scores
may not be adequate, and ICVH metrics should be considered in separate.
