American Heart Journal
Volume 155, Issue 2 , Pages 310-315 , February 2008

Atrial fibrillation and obesity—results of a meta-analysis

  • Nikolas Wanahita, MD, MHA

      Affiliations

    • Division of Cardiology, Beth Israel Medical Center, New York, NY
  • ,
  • Franz H. Messerli, MD

      Affiliations

    • Division of Cardiology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY
    • Corresponding Author InformationReprint requests: Franz H. Messerli, MD, FACC, FACP, Hypertension Program, Division of Cardiology, St. Luke's-Roosevelt Hospital, Columbia University College of Physicians and Surgeons, 1000 10th Avenue, Suite 3B-30, New York, NY 10019.
  • ,
  • Sripal Bangalore, MD, MHA

      Affiliations

    • Division of Cardiology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY
  • ,
  • Apoor S. Gami, MD

      Affiliations

    • Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN
  • ,
  • Virend K. Somers, MD, PhD

      Affiliations

    • Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN
  • ,
  • Jonathan S. Steinberg, MD

      Affiliations

    • Division of Cardiology, St. Luke's-Roosevelt Hospital Center, Columbia University College of Physicians and Surgeons, New York, NY

Received 3 August 2007 ,Accepted 1 October 2007.

References 

  1. Stamler R, Stamler J, Riedlinger WF, et al. Weight and blood pressure. Finding in hypertension screening of 1 million Americans. J Am Med Assoc. 1978;240:1607–1610
  2. Staessen J, Fagard R, Amery A. The relationship between body weight and blood pressure. J Hum Hypertens. 1988;2:207–217
  3. Messerli FH. Cardiopathy of obesity—a not-so-Victorian disease. N Eng J Med. 1986;314:378–380
  4. Hubert HB, Feinleib M, McNamara PM, et al. Obesity as an independent risk factor for cardiovascular disease: a 26-year follow up of participants in the Framingham Heart Study. Circulation. 1983;67:968–977
  5. Wilson PW, D'Agostino RB, Sullivan L, et al. Overweight and obesity as determinants of cardiovascular risk: the Framingham experience. Arch Intern Med. 2002;162:1867–1872
  6. Alpert MA. Obesity cardiomyopathy; pathophysiology and evolution of the clinical syndrome. Am J Med Sci. 2001;321:225–236
  7. McGavock JM, Victor RG, Unger RH, et al. Adiposity of the heart, revisited. Ann Intern Med. 2006;144:517–524
  8. Gottdiener JS, Reda DJ, Williams DW, et al. Left atrial size in hypertensive men: influence of obesity, race, and age. J Am Coll Cardiol. 1997;29:651–658
  9. Mokdad AH, Ford ES, Bowman BA, et al. Prevalence of obesity and diabetes, and obesity-related health risk factors, 2001. J Am Med Assoc. 2003;289:76–79
  10. Kenchaiah S, Evans JC, Levy D, et al. Obesity and the risk of heart failure. N Eng J Med. 2002;347:305–313
  11. Poirier P, Giles TD, Bray GA, et al. Obesity and cardiovascular disease: pathophysiology, evaluation, and effect of weight loss. Arterioscler Thromb Vasc Biol. 2006;26:968–976
  12. Abbott RD, Behrens GR, Sharp DS, et al. Body mass index and thromboembolic stroke in nonsmoking men in older middle age, The Honolulu Heart Program. Stroke. 1994;25:2370–2376
  13. Rhoads GG, Kagan A. The relation of coronary artery disease, stroke, and mortality to weight in youth and in middle age. Lancet. 1983;1:492–495
  14. Shinton R, Shipley M, Rose G. Overweight and stroke in the Whitehall study. J Epidemiol Community Health. 1991;45:138–142
  15. Kurth T, Gaziano JM, Berger K, et al. Body mass index and the risk of stroke in men. Arch Intern Med. 2002;162:2557–2562
  16. Feinberg WM, Blackshear JL, Laupacis A, et al. Prevalence, age distribution, and gender of patients with atrial fibrillation: analysis and implications. Arch Intern Med. 1995;155:469–473
  17. Chugh SS, Blackshear JL, Shen WK, et al. Epidemiology and natural history of atrial fibrillation: clinical implications. J Am Coll Cardiol. 2001;37:371–378
  18. Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention; the Anticoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285:2370–2375
  19. Steinberg JS. Atrial fibrillation: an emerging epidemic?. Heart. 2004;90:239–240
  20. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22:983–988
  21. Benjamin EJ, Wolf PA, D'Agostino RB, et al. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98:946–952
  22. Bradburn MJ, Deek JJ, Altman DG. Sbe24: METAN—an alternative meta-analysis command. Stata Technical Bull Reprints. 1998;8:86–100
  23. Galbraith RF. A note on graphical presentation of estimated odds ratios from several clinical trials. Stat Med. 1988;7:889–894
  24. Wilhemsen L, Rosengren A, Lappas G. Hospitalizations for atrial fibrillation in the general male population: morbidity and risk factors. J Intern Med. 2001;250:382–389
  25. Wang TJ, Parise H, Levy D, et al. Obesity and the risk of new-onset atrial fibrillation. JAMA. 2004;292:2471–2477
  26. Frost L, Hune LJ, Vestergaard P. Overweight and obesity as risk factors for atrial fibrillation or flutter: the Danish diet, cancer, and health study. Am J Med. 2005;118:489–495
  27. Murphy NF, MacIntyre K, Stewart S, et al. Long-tern cardiovascular consequences of obesity: 20-year follow-up of more than 15,000 middle-aged men and women (the Renfrew-Paisley study). Eur Heart J. 2006;27:96–106
  28. Gami AS, Hodges DO, Herges RM, et al. Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation. J Am Coll Cardiol. 2007;49:565–571
  29. Moulton MJ, Creswell LL, Mackey ME, et al. Obesity is not a risk factor for significant adverse outcomes after cardiac surgery. Circulation. 1996;94:II87–II92
  30. Engelman DT, Adams DH, Bryne JG, et al. Impact of body mass index and albumin on morbidity and mortality after cardiac surgery. J Thorac Cardiovasc Surg. 1999;118:866–873
  31. Brandt M, Harder K, Walluscheck KP, et al. Severe obesity does not adversely affect perioperative mortality and morbidity in coronary artery bypass surgery. Eur J Cardiothorac Surg. 2001;19:662–666
  32. Kuduvalli M, Grayson AD, Oo AY, et al. Risk of morbidity and in-hospital mortality in obese patients undergoing coronary artery bypass surgery. Eur J Cardiothorac Surg. 2002;22:787–793
  33. Reeves BC, Ascione R, Chamberlain MH, et al. Effect of body mass index on early outcomes in patients undergoing coronary artery bypass surgery. J Am Coll Cardiol. 2003;42:668–676
  34. Orhan G, Bicer Y, Aka SA, et al. Coronary artery bypass graft operations can be performed safely in obese patients. Eur J Cardiothorac Surg. 2004;25:212–217
  35. Zacharias A, Schwann TA, Riordan CJ, et al. Obesity and risk of new-onset atrial fibrillation after cardiac surgery. Circulation. 2005;112:3247–3255
  36. Habib RH, Zacharias A, Schwann TA, et al. Effects of obesity and small body size on operative and long-term outcomes of coronary artery bypass surgery: a propensity-matched analysis. Ann Thorac Surg. 2005;79:1976–1986
  37. Pan W, Hindler K, Lee VV, et al. Obesity in diabetic patients undergoing coronary artery bypass graft surgery is associated with increased postoperative morbidity. Anesthesiology. 2006;104:441–447
  38. Wigfield CH, Lindsey JD, Munoz A, et al. Is extreme obesity a risk factor for cardiac surgery? An analysis of patients with a BMI ≥ 40. Eur J Cardiothorac Surg. 2006;29:434–440
  39. Yap CH, Zimmet A, Mohajeri M, et al. Effect of obesity on early morbidity and mortality following cardiac surgery. Heart Lung Circ. 2007;16:31–36
  40. Messerli FH. Obesity in hypertension: how innocent a bystander?. Am J Med. 1984;77:1077–1082
  41. Messerli FH, Sundgaard-Riise K, Reisin ED, et al. Dimorphic cardiac adaptation to obesity and arterial hypertension. Ann Intern Med. 1983;99:757–761
  42. de Simone G, Daniels ST, Devereux RB, et al. Left ventricular mass and body size in normotensive children and adults: assessment of allometric relations and impact of overweight. J Am Coll Cardiol. 1992;20:1251–1260
  43. Hense HW, Gneiting B, Muscholl M, et al. The associations of body size and body composition with left ventricular mass: impacts for indexation in adults. J Am Coll Cardiol. 1998;32:451–457
  44. Alexander JK, Dennis EW, Smith WG, et al. Blood volume, cardiac output, and distribution of systemic blood flow in extreme obesity. Cardiovasc Res Cent Bull. 1962;1:39–44
  45. Gami AS, Pressman G, Caples SM, et al. Association of atrial fibrillation and obstructive sleep apnea. Circulation. 2004;110:364–367
  46. Gami AS, Friedman PA, Chung MK, et al. Therapy insight: interactions between atrial fibrillation and obstructive sleep apnea. Nat Clin Prac Cardiovasc Med. 2005;2:145–149
  47. Steinberg JS. Postoperative atrial fibrillation: a billion-dollar problem. J Am Coll Cardiol. 2004;43:1001–1003
  48. Baker WL, White CM. Post-cardiothoracic surgery atrial fibrillation: a review of preventive strategies. Ann Pharmacother. 2007;41:587–598

 Dr Messerli served as an ad hoc consultant/speaker for the following organizations: Abbott, GSK, Novartis, Pfizer, AstraZeneca, Bayer, Boehringer Ingelheim, BMS, Forest, Sankyo, and Sanofi. Dr Somers is supported by grants HL 73211, HL 65176, and MO1-RR00585 from the National institutes of Health (Bethesda, MD). He serves as a consultant for Respironics, Cardiac Concepts, ResMed, and Sepracor.

 This work was presented in part at the 2007 Annual Scientific Session of the American College of Cardiology, New Orleans, LA.

PII: S0002-8703(07)00783-1

doi: 10.1016/j.ahj.2007.10.004

American Heart Journal
Volume 155, Issue 2 , Pages 310-315 , February 2008