Association of arterial stiffness with incident atrial fibrillation: a cohort study

Zakaria Almuwaqqat, J. ’Neka S. Claxton, Faye L. Norby, Pamela L. Lutsey, Jingkai Wei, Elsayed Z. Soliman, Lin Y. Chen, Kunihiro Matsushita, Gerardo Heiss, Alvaro Alonso

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5 Scopus citations


Background: Stiff arteries increase left ventricular (LV) end-systolic workload, leading over time to left atrial and ventricular remodeling, and providing the substrate for atrial fibrillation (AF) development. We investigated if carotid femoral pulse wave velocity (cfPWV), a measure of central arterial stiffness, is associated with incident AF. Methods: In 2011–2013, cfPWV was measured in 3882 participants of the Atherosclerosis Risk in Communities Cohort Study (ARIC) without prevalent AF. Participants were followed through 2017 for the incidence of AF. Individuals were categorized in cfPWV quartiles based on visit measurements. Multivariable Cox regression models were used to evaluate the association of cfPWV with incident AF. Results: Mean age was 75 years (SD 5), 60% were female and 20% were African American. Over a median follow-up of 5.5 years we identified 331 incident cases of AF. cfPWV demonstrated U-shaped associations with AF risk. In models adjusted for age, race, center, sex, education levels, and hemodynamic and clinical factors, hazard ratios (HR) of AF for participants in the first, third and fourth quartiles were 1.49 (95% CI 1.06, 2.10), 1.59 (1.14, 2.10), and 1.56(1.10, 2.19), respectively, compared to those in the second quartile. Conclusion: Among community-dwelling older adults, low and high central arterial stiffness is associated with AF risk.

Original languageEnglish (US)
Article number247
JournalBMC Cardiovascular Disorders
Issue number1
StatePublished - Dec 2021

Bibliographical note

Funding Information:
The Atherosclerosis Risk in Communities study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, under Contract nos. (HHSN268201700001I, HHSN268201700003I, HHSN268201700005I, HHSN268201700004I, HHSN2682017000021, F32HL151163). This work was also supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR002378, TL1TR002382, and by the American Heart Association grant 16EIA26410001 (Alonso) and NHLBI award K24HL148521 and F32HL151163. The arterial stiffness component of the study was supported by grant R01AG053938. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2021, The Author(s).


  • Arterial stiffness
  • Atrial fibrillation
  • Hypertension


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