Arrhythmias & electrophysiology
Modifiable Risk Factors for Atrial Fibrillation/Flutter in the Association of Southeast Asian Nations: Global Burden of Disease 2021
Authors' conclusion
Metabolic risk factors remain the dominant contributors to AF/AFL mortality across ASEAN, with widening disparities across countries and sexes. Strengthening targeted prevention strategies is essential to reduce cardiovascular risk and achieve equitable progress by 2035.
Study context
- Population
- Atrial fibrillation/atrial flutter burden attributable to modifiable risk factors across the Association of Southeast Asian Nations (ASEAN)
- Comparison
- The burden of atrial fibrillation (AF)/atrial flutter (AFL) attributable to metabolic, behavioral, and environmental risk factors, stratified by sex
- Outcome
- ASMRs for AF/AFL attributable to modifiable risk factors
- Follow-up
- 1990 to 2021
Methodological detailsall 10 ASEAN nations (1990-2021), stratified by sex, Forecasts to 2035 were generated using validated time-series models
- All 10 ASEAN nations (1990-2021)
- Stratified by sex
- Forecasts to 2035 were generated using validated time-series models
Main finding
As reported in the abstract
Metabolic risks
1.30 (0.48-2.14) in 1990 to 1.78 (0.98-2.87) in 2021
Behavioral risks
0.42-0.45
Environmental risks
0.08-0.11
Further findings
Metabolic-attributable ASMR by country · 2021
- Vietnam (highest)
- 2.06
- Singapore (declined)
- 0.31
Metabolic disability-adjusted life years (DALYs) by country · 2021
- Indonesia (peak)
- 52.29
- Singapore (lowest)
- 12.35
Age-standardized mortality rates (ASMRs) and DALYs by sex · projected through 2035
- Males consistently showed higher ASMRs and DALYs than females, a gap projected to persist through 2035
Original publication
Modifiable Risk Factors for Atrial Fibrillation/Flutter in the Association of Southeast Asian Nations: Global Burden of Disease 2021. JACC Adv. Published 28 April 2026. doi:10.
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