Arrhythmias & electrophysiologyResearch article

Modifiable Risk Factors for Atrial Fibrillation/Flutter in the Association of Southeast Asian Nations

JACC AdvPublished

  • Global Burden of Disease 2021 data analysis
  • all 10 Association of Southeast Asian Nations (ASEAN) nations (1990-2021)
  • stratified by sex
  • Forecasts to 2035 were generated using validated time-series models

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

Main finding

As reported in the abstract

ASMRs for AF/AFL attributable to modifiable risk factors · 1990 to 2021

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. JACC Adv. Published 28 April 2026. doi:10.1016/j.jacadv.2026.102775

Summarised from the published abstract; every number is checked against it