Atrial Fibrillation in Black American Patients: A Review of Genetics, Risk Factors, and Outcomes

Heart Rhythm. 2024 Nov 6:S1547-5271(24)03540-9. doi: 10.1016/j.hrthm.2024.10.074. Online ahead of print.

Abstract

Atrial fibrillation (AF) is the most common arrhythmia in the U.S., impacting six million Americans with numbers projected to increase to 12 million by 2030. Racial paradox difference in the incidence and prevalence of AF exists among Black and White Americans. Black Americans are less prone to develop AF than White Americans, but they display a higher burden of modifiable risk factors for cardiovascular disease and higher rates of ischemic stroke. Data pertaining to the American Heart Association Life's Simple 7 (LS7) health metrics show that Black Americans have suboptimal LS7 scores compared to White Americans on average despite lower genetic predisposition to AF. This trend suggests the impact of cardiovascular health on the development and progression of AF. Social, genetic and lifestyle risk factors have been shown to play a role in the racial paradox and AF outcomes in Black Americans. This review will summarize factors contributing to the racial paradox and will discuss suggestions for improved health outcomes in Black Americans with AF.

Keywords: Atrial Fibrillation; Black American; modifiable risk factors; racial paradox; social determinants of health; social needs.

Publication types

  • Review