Who is most at risk for atrial fibrillation?

Dr. Jeanne Morrison, PhD
Family Practitioner

You can develop atrial fibrillation as an adult. Not only is it possible, but your risk for developing atrial fibrillation increases with your age. As you get older, you should discuss ways to reduce your risk with your doctor, such as lowering your blood pressure.

Certain risk factors make it more likely to develop atrial fibrillation, but often the cause remains unclear. Leading risk factors include:
  • coronary heart disease
  • heart attack
  • heart failure
  • medication and chemical changes
  • heart valve disease
  • endocarditis (inflamed heart muscle or lining)
  • recent heart surgery
  • atherosclerosis (arteries lined with fatty deposits)
  • angina (chest pain due to reduced blood flow to the heart muscle)
  • a birth defect in the heart
  • severe lung disease
  • blood clots in the lung
  • emphysema
  • asthma
Gender and age also affect both the likelihood of developing atrial fibrillation and the severity of the condition. Men are slightly more likely than women to have atrial fibrillation, but women who are diagnosed with the disease have a greater risk over time for premature death. Older people are more likely to have atrial fibrillation than younger people. Additional risk factors include thyroid disorders, diabetes, high blood pressure, excessive alcohol intake, and cigarette or drug use, including caffeine.

More than 2 million people in the United States have atrial fibrillation (AF). It affects both men and women.

The risk of AF increases as you age. This is mostly because as you get older, your risk for heart disease and other conditions that can cause AF also increases. However, about half of the people who have AF are younger than 75.

AF is uncommon in children.

Major Risk Factors
AF is more common in people who have heart diseases or conditions, such as:
    • Coronary heart disease
    • Heart failure
    • Rheumatic heart disease
    • Structural heart defects, such as mitral valve disorders
    • Pericarditis (a condition in which the membrane, or sac, around your heart is inflamed)
    • Congenital heart defects
    • Sick sinus syndrome (a condition in which the heart's electrical signals don't fire properly and the heart rate slows down; sometimes the heart will switch back and forth between a slow rate and a fast rate

AF also is more common in people who are having heart attacks or who have just had surgery.

Other Risk Factors
Other conditions that increase AF risk include hyperthyroidism (too much thyroid hormone), obesity, high blood pressure, diabetes, and lung disease.

Other factors also can increase your risk of AF. For example, drinking large amounts of alcohol, especially binge drinking, increases your risk. Even modest amounts of alcohol can trigger AF in some people. Caffeine or psychological stress also may trigger AF in some people.

Some evidence suggests that people who have sleep apnea are at greater risk for AF. Sleep apnea is a common disorder in which you have one or more pauses in breathing or shallow breaths while you sleep.

Metabolic syndrome also increases your risk of AF. People who have this condition have a group of risk factors that increase their risk of heart disease and other health problems.

Recent research suggests that people who receive high-dose steroid therapy are at increased risk of AF. This therapy, which is commonly used for asthma and certain inflammatory conditions, may act as a trigger in people who already have other AF risk factors.

This answer from the National Heart, Lung and Blood Institute has been reviewed and/or edited by Dr. William D. Knopf.

Dr. Indrajit Choudhuri, MD
Cardiologist (Heart Specialist)

People with heart valve disease, heart failure, hypertension, and various forms of heart and lung disease are all at risk for atrial fibrillation.

Donna Hill Howes, RN
Family Practitioner
Healthy adults can get atrial fibrillation, but the most common cause of atrial fibrillation is underlying heart disease, whether it is coronary heart disease (plaque in the arteries impairs blood flow, which can trigger a heart attack) or heart failure (the heart can't pump out enough blood with each beat). You can be generally healthy, though, and have a congenital heart defect that leads to atrial fibrillation. There is also some evidence that people who drink too much alcohol (more than two drinks a day) may be at increased risk.
Many conditions can increase the risk for atrial fibrillation (Afib):
  • High blood pressure
  • Age: Afib is more common in people over 60 years old
  • Obstructive sleep apnea, a condition that causes you to stop breathing temporarily while you sleep
  • Obesity
  • Heart failure
  • Thyroid disease
  • Heart valve disease
  • Lung disease
  • A heart attack caused by coronary artery disease
  • Family history: Research has shown some genes are linked to Afib
In some cases of Afib, the cause can't be identified.

Adults are more and more at risk for atrial fibrillation as they age. This is usually because they are also at higher risk for heart and other health problems that may cause atrial fibrillation. People who have heart disease, lung disease, high blood pressure, thyroid problems, sleep apnea, and a family history are at increased risk for atrial fibrillation as well as adults who smoke or drink alcohol. An adult of advanced age with heart disease and other risk factors will be at even higher risk for atrial fibrillation.

Dr. Jose Nazari, MD
Cardiac Electrophysiologist
The risk is highest in people with hypertension, heart valve abnormalities, and those over the age of 60.
According to the American Heart Association, those with advanced age, heart disease such as valvular issues and coronary artery disease, high blood pressure, sleep apnea, alcohol abuse and lung disease such as asthma and COPD are at higher risk of developing atrial fibrillation.
Dr. Joshua D. Stern, MD

There are several well-established risk factors for atrial fibrillation (AFib), including:

  • Coronary artery disease and heart failure—the most frequently associated with atrial fibrillation
  • Rheumatic heart disease, which affects the valves of the heart
  • Congenital heart abnormalities (inherited heart defects)
  • Hypertension
  • Diabetes
The risk increases with age, especially over 60. In general, people with the following conditions are most at risk:
  • Coronary artery disease;
  • Congenital heart disease;
  • Heart failure;
  • Hypertension (high blood pressure);
  • Cardiomyopathy;
  • Diseased heart valves;
  • Chronic lung disease;
  • Pulmonary embolism.

Atrial fibrillation (AF) affects men and women of all ages and races, but your risk increases as you age. This is because for most people, your risk of heart disease and other conditions that cause AF also increase as you age. And adopt poor choices like lunch meats or cigarettes then suffer the slings and arrows of stress from relationships gone bad. So, if you’ve had a heart attack, diseased heart valves, or heart surgery, you may be at risk for AF. The same is true if you have high blood pressure, especially if you’re not taking meds, getting 10,000 steps a day, and eating like a Med (avoiding the five food felons). You are also at risk if you have

  • an overactive thyroid
  • sleep apnea
  • diabetes
  • metabolic syndrome
  • have more than one drink a day if you’re a lady or more than two drinks a day if you’re a guy
  • a family history of a-fib
  • are frequently stressed
  • drink caffeinated beverages like they’re water
Dr. Douglas E. Severance, MD
Family Practitioner
Atrial fibrillation is more common in those who have had a heart attack, or are having a heart attack. It is also more common in people who just had surgery. Other people at risk for atrial fibrillation are those with hyperthyroidism, hypertension (high blood pressure), obesity, lung disease, metabolic syndrome, diabetes, or sleep apnea. Certain lifestyle habits can increase the chance of atrial fibrillation, such as taking over-the-counter medications for a cold or flu. Sometimes drinking too much caffeine or alcohol or smoking can increase the risk of atrial fibrillation.

Dr. Audrey K. Chun, MD
Geriatric Medicine Specialist
While atrial fibrillation (AFib) can occasionally run in families, in most cases it doesn't. Risk factors include older age, heart disease, high blood pressure, sleep apnea and thyroid problems. The symptoms of AFib include palpitations, shortness of breath, chest pain, and lightheadedness, but some people have no symptoms.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.