Severe heart disease is escalating in incidence

Atrial fibrillation, also known as irregular heart rhythm, is one of the most common cardiovascular diseases. In Denmark, more than 130,000 people live with the disease, and every year over 20,000 new cases are diagnosed.

Researchers from the Danish Center for Health Services Research at Aalborg University have examined the incidence of atrial fibrillation and complications following atrial fibrillation in the entire Danish population in the period 2000-2022. The results reveal that the number of individuals diagnosed with atrial fibrillation during their lifetime has increased from 1 out of 4 to 1 out of 3. In other words, every third one of us can expect to be diagnosed with atrial fibrillation, which typically manifests itself as fatigue, palpitations, and shortness of breath. The study has just been published in the prestigious journal the British Medical Journal (BMJ).

According to the Danish researchers, the large increase in risk is not only a consequence of negative developments. As a population, we are getting older, and we have become better at treating several heart diseases that people previously died from. Therefore, we are instead left with an aging population with more or less worn hearts. Another important explanation is that doctors have become better at finding the disease than before.

Postdoctoral researcher Nicklas Vinter, MD, PhD from the Danish Center for Health Services Research explains:

- Ultimately, it is positive that people live longer and thus reach an age where they are at risk of getting other diseases. But we are dealing with a growing disease that is associated with serious complications, and it will pose a significant challenge to health services. Preventive efforts against atrial fibrillation are important to reduce the growing incidence.

Heart failure is the most common complication

The best-known complications of atrial fibrillation are stroke and heart failure. The new study shows that 1 out of 5 encounters a stroke after atrial fibrillation, and the risk has only decreased slightly in the last 20 years. At the same time, 2 out of 5 develop heart failure after atrial fibrillation, which is far more than previously assumed. Heart failure is the most common complication, and the risk of getting heart failure is twice as high as getting a stroke after atrial fibrillation. The risk of getting heart failure after atrial fibrillation has remained unchanged for the last 20 years.

- That the risk of heart failure after atrial fibrillation is so high is the most surprising finding. Heart failure after atrial fibrillation is associated with a poor prognosis, and every third with atrial fibrillation dies of heart failure. Therefore, it is also crucial that action is taken, says Nicklas Vinter.

The greatest danger is not taking heart failure seriously

The good news is, according to the researchers, that there are things we can do. For patients with atrial fibrillation, it is a reminder that they should remember to take the medicine they have been prescribed and strive to follow the classic advice regarding diet, smoking, alcohol, and exercise.

But Nicklas Vinter wants to reach out to healthcare professionals in particular.

- The biggest problem arises if prevention and treatment of heart failure after atrial fibrillation do not get greater attention. In the international guidelines for the treatment of atrial fibrillation, prevention of stroke is a main priority. The preventive treatment of stroke should hopefully become even better in the future, but now prevention and treatment of heart failure needs to be prioritized higher.

The study was conducted in collaboration with Tufts Medical Center, Boston, and Boston Medical Center, Boston. The work is supported by the Danish Cardiovascular Academy.