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Eur Heart J. 2019 Jun 17. pii: ehz390. doi: 10.1093/eurheartj/ehz390. [Epub ahead of print]

Weight and weight change and risk of atrial fibrillation: the HUNT study.

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Department of Public Health and Nursing, Norwegian University of Science and Technology, Mauritz Hanssens gate 2, NO-7489 Trondheim, Norway.
Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Prinsesse Kristinas gate 3, Postboks 8905, 7491 Trondheim, Norway.
Department of Cardiology, St. Olavs Hospital, Prinsesse Kristinas gate 3, Postboks 3250, 7030 Trondheim, Norway.
Department of Cardiology, Vestfold Hospital Trust, Halfdan Wilhelmsens alle 17, Postboks 2168, 3103 Tønsberg, Norway.
Department of Epidemiology and Biostatistics, Imperial College London, South Kensington, London SW7 2AZ, UK.
Department of Nutrition, Bjørknes University College, Lovisenberggata 13, 0456 Oslo, Norway.
Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Trondheimsveien 235, OUS Aker, 0586 Oslo, Norway.
Stroke Unit, Department of Internal Medicine, St Olav's Hospital, Harald Hardrådes gate 14, 7030 Trondheim, Norway.
Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate 8, N-7491 Trondheim, Norway.
Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215, USA.
Department of Neurology, Medical School, University of Pécs, Rét u. 2, 7623 Pécs, Hungary.
Institute of Behavioural Sciences, Semmelweis University, Nagyvárad tér 4, H-1089 Budapest, Hungary.



Although obesity has been associated with risk of atrial fibrillation (AF), the associations of long-term obesity, recent obesity, and weight change with AF risk throughout adulthood are uncertain.


An ambispective cohort study was conducted which included 15 214 individuals. The cohort was created from 2006 to 2008 (the baseline) and was followed for incident AF until 2015. Weight and height were directly measured at baseline. Data on previous weight and height were retrieved retrospectively from measurements conducted 10, 20, and 40 years prior to baseline. Average body mass index (BMI) over time and weight change was calculated. During follow-up, 1149 participants developed AF. The multivariable-adjusted hazard ratios were 1.2 (95% confidence interval 1.0-1.4) for average BMI 25.0-29.9 kg/m2 and 1.6 (1.2-2.0) for average BMI ≥30 kg/m2 when compared with normal weight. The association of average BMI with AF risk was only slightly attenuated after adjustment for most recent BMI. In contrast, current BMI was not strongly associated with the risk of AF after adjustment for average BMI earlier in life. Compared with stable BMI, both loss and gain in BMI were associated with increased AF risk. After adjustment for most recent BMI, the association of BMI gain with AF risk was largely unchanged, while the association of BMI loss with AF risk was weakened.


Long-term obesity and BMI change are associated with AF risk. Obesity earlier in life and weight gain over time exert cumulative effects on AF development even after accounting for most recent BMI.


Atrial fibrillation; BMI; Weight; Weight change


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