Atrial fibrillation [AF], the most common arrhythmia in the United States, affects an estimated 2.2 million people in this country alone. The prevalence of AF grows incrementally with increasing age, and the majority of people living with AF are over the age of 65 years. For people less than 55 years old the prevalence is 0.1%, compared to an approximate 10% prevalence in people over the age of 80 years. The incidence of AF is also on the rise resulting in predictions for AF to affect 10 million Americans by the year 2050. This increase is likely due to the ongoing aging of the population and an increase in the prevalence of individuals in the community with one or more risk factors for developing AF. Along these same lines, people are now living longer with medical conditions such as diabetes mellitus and hypertension, which predispose individuals to developing AF. The trend of increased AF prevalence in the U.S. in recent years and the projected continued increase over the next few decades will raise AF to unprecedented levels. In fact, current projections based on data from the Framingham Heart Study put the lifetime risk for developing AF in this country at approximately 16% for individuals around 40 years of age, and up to 25% if there is a prior history of congestive heart failure or myocardial infarction. Several clinical risk factors have been linked to the development of AF, particularly advancing age which is associated with structural changes such as fibrosis in the heart that predispose older individuals to AF. In addition to age, other clinical risk factors for developing AF include male sex, cardiovascular risk factors such as hypertension and diabetes mellitus, and other cardiac conditions such as valvular heart disease, prior myocardial infarction, and congestive heart failure.4-6 Along with these traditional risk factors, more recently recognized risk factors such as obesity and sleep apnea have also been recognized. Echocardiography has also allowed detection of various validated cardiac structural risk factors such as left ventricular hypertrophy and increased left atrial size. Although race has never been considered a risk factor for developing AF, there is evidence to suggest that whites develop AF more than other racial groups out of proportion to the prevalence of the clinical risk factors mentioned here. As little is known about the interaction of race and AF, this paper seeks to review all relevant published data on race and AF.Master of Public Healt
