Youth doesn’t protect against heart condition Afib, study finds
For people under the age of 50 or 60, a few minutes of heart flutters might seem like a fluke. Too much caffeine, stress, minor dehydration or another benign trigger might also make the list of assumed causes.
While the simplest explanation can often be the correct one, heart palpitations are one possible symptom of atrial fibrillation, or Afib. And new research from UPMC shows that common assumptions about what ages need to be concerned about the condition need to be updated.
The condition, an electrical malfunction of the heart’s upper chambers, is on the rise among younger people and, according to UPMC Heart and Vascular Center research published Monday in the journal Circulation Arrhythmia and Electrophysiology, can lead to life-threatening consequences, even among younger groups.
“Common knowledge among cardiologists is that, in people under 65, Afib is extremely uncommon and not detrimental. But there really hasn’t been any data to back that up,” said the study’s lead author, UPMC electrophysiologist and assistant professor of medicine at Pitt, Dr. Aditya Bhonsale, in a news release.
Dr. Bhonsale’s research group is among the first to examine a large group of Afib patients under age 65 in the U.S.
The study included 67,000 UPMC patients seeking care for Afib from January 2010 through December 2019. Over 17,300 of those — or around 25% — were younger than 65, a rate that soars above the commonly understood prevalence of 2%.
“At UPMC, we’ve been seeing a lot more young patients with Afib in recent years, and have been interested in understanding the real-world clinical course of these individuals,” Dr. Bhonsale said in the release.
With 40-some hospitals under the hospital system’s umbrella, he said, “UPMC was uniquely positioned to ask this question.”
Here’s the short answer: For those under age 65 with Afib, survival rates were 1.3 to 1.5 times worse among men and 1.82 to 3.16 worse among women, compared to people in that age group without the condition.
But there’s more to the story.
In this study, people aged 50 to 65 had many other health conditions, “comorbidities” in medical lingo, contributing to their overall state of health, including 58% with high blood pressure, 23% with diabetes and 51% with high cholesterol, among other risk factors.
While each of those conditions present independent risks for outcomes such as stroke and heart failure, Afib alone causes about 1 in 7 strokes, as the atria’s inefficient contractions allow blood to pool there and clot, which can then migrate to the brain and block blood flow.
The risk of stroke due to Afib increases by about 20%, however, in areas with poor air quality — such as pockets within Allegheny County — as was concluded by another group of Heart and Vascular Institute researchers in a September 2020 publication in the American Medical Association’s JAMA Network Open.
“Common knowledge among cardiologists is that, in people under 65, Afib is extremely uncommon and not detrimental. But there really hasn’t been any data to back that up.” Dr. Aditya Bhonsale
UPMC electrophysiologist and assistant professor of medicine
The data published Monday not only reaffirms the growing population of younger Afib patients — and the need to observe cardiac symptoms carefully, regardless of age — but also provides a sobering look at the whole-patient pictures of those diagnosed with this arrhythmia.
As a result, the closing remarks of the study emphasize that management of these younger patients, in particular, “must be in the context of their individual risk factor burden,” including lifestyle management and non-cardiac risk factors, each facet of which indicates future opportunities for research.