Why wealthier countries often have higher AFib death rates

The wealthiest European countries have higher death rates from atrial fibrillation (AFib) than less wealthy countries, according to a new analysis published in European Heart Journal.

The study’s authors examined data from 1990 to 2017 in Austria, Belgium, Bulgaria, Croatia, Czech Republic, Denmark, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Netherlands, Poland, Portugal, Romania, Spain, Sweden and the UK.

Overall, the team wrote, exploring AFib incidence and mortality throughout Europe revealed “unique patterns” worthy of examination. For instance, the countries considered to be among Europe’s wealthiest—Austria, Denmark and Sweden, for example—had the highest death rates for both men and women.

This trend is likely because people in wealthier countries are more likely to be obese or consume alcohol. Another potential reason for this trend is the “survivor effect,” meaning that patients live longer in the wealthier countries and are then more likely to die of a condition such as AFib.

“Another possibility is that atrial fibrillation is less well recognized in poorer countries in a systematic way,” co-lead author Markus Sikkel, BSc, MBBS, MRCS, MRCP, PhD, a cardiologist at the University of British Columbia in Vancouver, said in a prepared statement. “We think this is likely to be a real difference and not just an artifact of better documentation in richer nations judging by the findings of previous studies.”

The study revealed other noteworthy trends as well. For instance, AFib outcomes for women were consistently worse than they were for men—not just in the wealthiest of countries, but in all countries.

“This suggests that there is widespread healthcare inequality between the sexes across Europe, or that there are biological differences between them in terms of their risk of adverse outcomes from AFib,” Sikkel et al. wrote in their analysis.