Recent trends and future projections of atrial fibrillation epidemiology in a large european population.

BACKGROUND

Atrial fibrillation (AF) is a major public health concern with a rising global epidemiological burden and marked regional variability. We analysed AF epidemiology, trends, and future projections in a large Mediterranean cohort.

METHODS

Population-based observational study using validated health records from the System for the Development of Research in Primary Care (>80% of the Catalan population). Adults aged ≥40 years were followed from 2009 to 2021 to assess AF prevalence and incidence trends. Projections to 2050 used official population forecasts.

RESULTS

The number of AF cases increased by 62%, from 91 423 in 2009 to 148 009 in 2021. AF prevalence increased by 40%, from 3.18% in 2009 to 4.46% in 2021 (estimated annual percentage change 2.62%), with the greatest relative rise in individuals <50 years. Conversely, AF incidence remained stable. AF prevalence was higher in men than women throughout the study (2021: 4.87% vs 4.07%; P<.001) and increased steeply with age, reaching 14.1% in those ≥70 years in 2021. The lifetime risk to develop AF at age 40 was 44.4% in men and 33.1% in women. By 2050, the number of individuals with AF is projected to double, reaching 346 302 (6.3%) in Catalonia and 2 236 072 (6.5%) in Spain.

CONCLUSIONS

in a large Mediterranean population AF prevalence increased by >40% over 13 years. The number of individuals diagnosed with AF is expected to double by 2050. The fastest growth in younger adults highlights the need for targeted prevention and risk factor control to curb future AF epidemiological burden.