Early life predictors of atrial fibrillation-related mortality: Evidence from the health and retirement study

Prior research found that Americans born in 6 southeastern states (the AF-risk zone) had elevated risk of AF-related mortality, but no mechanisms were identified. We hypothesized the association between AF-related mortality and AF-risk zone birth is explained by indicators of childhood social disadvantage or adult risk factors. In 24,323 participants in the US Health and Retirement Study, we found that birth in the AF-risk zone was significantly associated with hazard of AF-related mortality. Among whites, the relationship was specific to place of birth, rather than place of adult residence. Neither paternal education nor subjectively assessed childhood SES predicted AF-related mortality. Conventional childhood and adult cardiovascular risk factors did not explain the association between place of birth and AF-related mortality.

► U.S. Health and Retirement Study participants (n=24,323) were followed an average of 9.7 years for AF-related mortality. ► Birth in the AF-risk zone was significantly associated with hazard of AF-related mortality. ► Among whites, the relationship was specific to place of birth, rather than place of adult residence. ► Major childhood and adult socio-economic risk factors previously shown to predict stroke did not predict AF-related mortality.