Managed Care Outlook

Millions more will deal with atrial fibrillation

The number of people with atrial fibrillation (AF) will more than double in the next two decades, growing from about 5 million in 2010 to 12 million in 2030, according to a study in the American Journal of Cardiology. This can be pinned partly on the aging population “but also reflects the empirical fact that the incidence rate of AF is increasing,” the study states. The authors say that the higher prevalence might be a matter of better methods used to detect hypertension. They also cite increased risk factors, such as obesity and diabetes.

The study reviews a database of 14 million people enrolled in large commercial health plans and Medicare Advantage plans between 2001 and 2008. “The age- and gender-adjusted AF incidence rate, standardized to the general U.S. population, grew from approximately 220 per 100,000 in 2002 to about 350 per 100,000 in 2007… corresponding to a 9.2% annual growth rate.”

The authors concede that while the AF rate will certainly increase, “there exists a wide range of uncertainty around the magnitude of future trends,” and it could fall between 7.8 million and 17.7 million by 2030.

Projections of future prevalence of atrial fibrillation

Projections of future prevalence of atrial fibrillation

Probabilistic range of uncertainty around the projected AF prevalence estimate for sensitivity analysis by simultaneously varying all the input parameters used in model. The probabilistic range of AF prevalence estimates is represented by the upper 10% likelihood (blue dashed line) and the lower 10% likelihood estimate (green dotted line) around the base AF prevalence estimate with logarithmic incidence growth rate projection (purple solid line).

Source: Am J Cardiol. 2013 Jul 4. pii: S0002–9149(13)01288–5. doi: 10.1016/j.amjcard.2013.05.063.

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