Abstract
BACKGROUND: Self-rated health (SRH) is easy to obtain and is known to be a good predictor for mortality and several comorbidities, including cardiovascular disease, but its relation to atrial fibrillation (AF) is largely unknown. We determined the association of SRH with risk of developing AF. METHODS: We conducted a pooled cohort analysis of participants in the Atherosclerosis Risk in Communities Study (ARIC) (n = 10,255; mean age, 63 years), the Trøndelag Health Study (HUNT-3 Study) (n = 43,668, mean age, 53 years), and the Multi-Ethnic Study of Atherosclerosis Study (MESA) (n = 5037, mean age, 66 years) cohorts to examine the association of SRH with risk of atrial fibrillation (AF). We categorized SRH as "poor or fair", "good", or "very good or excellent". Incident AF was identified via visit electrocardiograms, hospital discharge codes, or Medicare claims. We used Cox regression to quantify the association of baseline SRH category and AF risk in each cohort. Models were adjusted for demographics, body mass index, tobacco use, alcohol, diabetes, hypertension, cholesterol, cardiovascular disease, and physical activity. We pooled the hazard ratios (HR) and 95 % CIs using a fixed-effects model. RESULTS: Over a mean of 16±6, 9 ± 2, and 10±4 years of follow-up, 2340 (22.8 %), 1525 (3.5 %), and 879 (17.4 %) incident AF events occurred in ARIC, HUNT-3, and MESA respectively. Lower SRH categories were associated with higher AF risk in each cohort and in the pooled analysis: HR 1.11 (95 % CI 1.02 to 1.20) for good SRH; and 1.40 (95 % CI, 1.26 to1.55) for fair or poor SRH compared to very good or excellent SRH. CONCLUSIONS: Worse SRH was independently associated with a higher risk of developing AF. SRH is an easily obtainable metric and may help to additionally identify individuals at higher risk for AF.