High neck circumference is associated with incident atrial fibrillation (AF), according to a recent study published in the Journal of the American Heart Association.

In this study, 4093 participants from the Framingham Heart Study Offspring, New Offspring Spouse, Third Generation, Omni 1 and Omni 2 cohorts were selected for this study to explore the association between neck circumference and new onset of AF over a mean follow up period of 11 years. More than half (55%) of them were women. Data for neck circumference, BMI and waist circumference was available for these participants, who did not have AF at baseline. They were followed up for 11 years (mean). The neck circumference was measured by placing the upper border of the tape measure just below the laryngeal prominence at 90o to the long axis of the neck.

Incident AF was documented in 571 participants during the follow up. An association between high neck circumference (≥17 inches in men and ≥14 inches in women) and incident AF was noted (sHR for high versus low: 1.58). This association was strongest among obese participants. The risk for new onset of AF was higher among patients with high neck circumference compared to participants with lower neck circumference with subdistribution hazard ratio (sHR) of 1.58. The incidence of AF among persons with low neck circumference was 10.8 per 1,000 person-years versus  16.2 per 1,000 person-years among those with high neck circumference. The increased risk persisted even after adjustment for the traditional cardiovascular risk factors like BMI (sHR = 1.51), waist circumference (sHR = 1.47) and height/weight (sHR = 1.37). Participants with high neck circumference also had higher mortality compared to those with low neck circumference; 16.7 per 1,000 person-years vs 14.2 per 1,000 person-years respectively.

By demonstrating an association between neck circumference and AF beyond “classic” obesity measures, this study has suggested high neck circumference as a potential risk factor for AF, one which can be easily measured.

Reference

1. Kornej J, et al. Neck Circumference and Risk of Incident Atrial Fibrillation in the Framingham Heart Study. J Am Heart Assoc. 2022 Feb 15;11(4):e022340. doi: 10.1161/JAHA.121.022340.