Temporal Trends in Incidence, Prevalence, and Mortality of Atrial Fibrillation in Primary Care

<jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Incidence and prevalence of atrial fibrillation ( <jats:styled-content style="fixed-case">AF</jats:styled-content> ) are expected to increase dramatically; however, we currently lack comprehensive data on temporal trends in unselected clinical populations. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> Analysis of the <jats:styled-content style="fixed-case">UK</jats:styled-content> Clinical Practice Research Datalink ( <jats:styled-content style="fixed-case">CPRD</jats:styled-content> ) from 1998 to 2010 of patients with incident <jats:styled-content style="fixed-case">AF</jats:styled-content> , excluding major valvular disease, linked to hospital admission data and national statistics. Fifty‐seven thousand eight hundred eighteen adults were identified with mean age 74.2 ( <jats:styled-content style="fixed-case">SD</jats:styled-content> , 11.7) years and 48.3% women. Overall age‐adjusted incidence of <jats:styled-content style="fixed-case">AF</jats:styled-content> per 1000 person years was 1.11 (95% <jats:styled-content style="fixed-case">CI</jats:styled-content> , 1.09–1.13) in 1998–2001, 1.33 (1.31–1.34) in 2002–2006, and 1.33 (1.31–1.35) in 2007–2010. Ongoing increases in incidence were noted for patients aged ≥75 years, with similar temporal patterns in women and men. Associated comorbidities varied over time, with a constant prevalence of previous stroke, increases in hypertension and diabetes mellitus, and decreases in ischemic heart disease. Among patients aged 55 to 74 years, there was a significant reduction in mortality over time ( <jats:italic>P</jats:italic> <0.001), but mortality rates in patients aged ≥75 years remained static at 14% to 15% per year ( <jats:italic>P</jats:italic> =0.84). Projections of <jats:styled-content style="fixed-case">AF</jats:styled-content> prevalence demonstrated a constant yearly rise, increasing from 700 000 patients in 2010 to between 1.3 and 1.8 million patients with <jats:styled-content style="fixed-case">AF</jats:styled-content> in the United Kingdom by 2060. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> In a large general practice population, incident <jats:styled-content style="fixed-case">AF</jats:styled-content> increased and then plateaued overall, with a continued increase in patients aged ≥75 years. The large projected increase in <jats:styled-content style="fixed-case">AF</jats:styled-content> prevalence associated with temporal changes in <jats:styled-content style="fixed-case">AF</jats:styled-content> ‐related comorbidities suggests the need for comprehensive implementation of <jats:styled-content style="fixed-case">AF</jats:styled-content> prevention and management strategies. </jats:p> </jats:sec>