Atrial fibrillation: a major contributor to stroke in the elderly. The Framingham Study

TLDR

Chronic atrial fibrillation without valvular disease is linked to increased stroke incidence. The study examined how atrial fibrillation influences stroke risk across ages in a large cohort. The authors analyzed 5184 Framingham Heart Study participants over 30 years of follow‑up to assess age‑related stroke risk. During 30 years, chronic atrial fibrillation developed in 303 individuals, age‑specific stroke incidence rose from 0.2 to 39.0 per 1000, atrial fibrillation accounted for 14.7% of strokes—growing from 6.7% to 36.2% with age—and remained a significant contributor at all ages. Published in Arch Intern Med 1987;147:1561‑1564.

Abstract

• Chronic atrial fibrillation without valvular disease has been associated with increased stroke incidence. The impact of atrial fibrillation on the risk of stroke with increasing age was examined in 5184 men and women in the Framingham Heart Study. After 30 years of follow-up, chronic atrial fibrillation appeared in 303 persons. Age-specific incidence rates steadily increased from 0.2 per 1000 for ages 30 to 39 years to 39.0 per 1000 for ages 80 to 89 years. The proportion of strokes associated with this arrhythmia was 14.7%, 68 of the total 462 initial strokes, increasing steadily with age from 6.7% for ages 50 to 59 years to 36.2% for ages 80 to 89 years. In contrast to the impact of cardiac failure, coronary heart disease, and hypertension, which declined with age, atrial fibrillation was a significant contributor to stroke at all ages. (<i>Arch Intern Med</i>1987;147:1561-1564)