Gastroesophageal reflux disease symptoms and risk of atrial fibrillation in a population-based cohort study (the HUNT study)

PLoS One. 2024 May 31;19(5):e0304624. doi: 10.1371/journal.pone.0304624. eCollection 2024.

Abstract

Aims: Gastroesophageal reflux disease (GERD) may influence the risk of atrial fibrillation (AF). We investigated the association between symptoms of GERD and AF in the Trøndelag Health Study (HUNT).

Methods: The study cohort comprised 34,120 adult men and women initially free of AF with information on GERD symptoms. Participants were followed from the baseline clinical examination (1 October 2006 to 30 June 2008) to March 31, 2018.

Results: During a median follow-up of 8.9 years, 1,221 cases of AF were diagnosed. When looking at the whole population, participants with much GERD symptoms did not have an increased risk of AF (HR: 1.01; CI: 95%, 0.82 to 1.24) while participants with little GERD symptoms had a 14% lower risk of AF compared those with no GERD symptoms (HR: 0.86; CI: 95%, 0.76 to 0.97). Among younger participants (<40 years of age), the risk of AF had a trend towards increased risk with increasing symptom load of GERD (little GERD symptoms, HR: 3.09; CI: 95%, 0.74 to 12.94 and much GERD symptoms, HR: 5.40; 95% CI: 0.82 to 35.58). Among older participants (≥65 years of age), we saw a slightly reduced risk of AF in participants with little symptoms (HR: 0.84; CI: 0.72 to 0.97) and no association among those with much GERD symptoms (HR: 1.06; 95% CI: 0.82 to 1.36).

Conclusion: We did not find support for a clinically important association between symptoms of GERD and AF across all age groups but for some younger people, GERD might play a role in the development of AF. However, our estimates for this age group were very imprecise and larger studies including younger individuals are warranted.

MeSH terms

  • Adult
  • Aged
  • Atrial Fibrillation* / epidemiology
  • Atrial Fibrillation* / etiology
  • Cohort Studies
  • Female
  • Gastroesophageal Reflux* / complications
  • Gastroesophageal Reflux* / epidemiology
  • Humans
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Risk Factors

Grants and funding

Center for Innovative Medicine (https://cimed.ki.se/), Region Stockholm, Grant/Award Number: 20190797, Åke Wibergs Stiftelse (https://ake-wiberg.se/), Grant/Award number: M19-0424, Swedish Heart-Lung Foundation (Hjärt-Lungfonden)(https://www.hjart-lungfonden.se/) Grant/Award Number: 20190301, 20200537, and 202110302 and Swedish research Council (Vetenskapsrådet)(https://www.vr.se/) Grant/Award Number: 2019‐06102 and 2021-00202 to ND. The funders did not have any role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.