International Journal of Medical Sciences

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18 October 2017

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Int J Med Sci 2013; 10(7):804-811. doi:10.7150/ijms.5998

Research Paper

Areca Nut Chewing and Risk of Atrial Fibrillation in Taiwanese Men: A Nationwide Ecological Study

Wei-Chung Tsai1,2, Chung-Yu Chen3, Hsuan-Fu Kuo1, Ming-Tsang Wu4,5, Wei-Hua Tang1, Chih-Sheng Chu1, Tsung-Hsien Lin1, Ho-Ming Su1,2, Po-Chao Hsu1, Shih-Jie Jhuo1, Ming-Yen Lin5, Kun-Tai Lee1✉, Sheng-Hsiung Sheu1, Wen-Ter Lai1

1. Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;
2. Department of Internal Medicine, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan;
3. College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan;
4. Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;
5. Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan.

Abstract

Background: Areca nut chewing is associated with the risk of obesity, metabolic syndrome, hypertension, and cardiovascular mortality. Although a few case reports or case series have suggested the link between areca nut chewing and cardiac arrhythmias, information about the relationship between areca nut chewing and atrial fibrillation (AF) is lacking. Thus, a nationwide ecological study was conducted to investigate this.

Methods: Two national datasets, the nationwide population-based 2005 Taiwan National Health Insurance Research dataset (NHIRD) and the 2005 National Health Interview Survey (NHIS), were used for analyses. The clinical characteristics, inhabited area and medical histories for 375,360 eligible males were retrieved from the 2005 NHIRD. Health related behaviors including areca nut chewing, cigarette smoking, infrequent vegetable eating, and exercise habit were collected from the 2005 NHIS. The prevalence of AF and the areca nut chewing rate were evaluated by multivariate analysis.

Results: Of the 375,360 males (mean age, 44 years old), 1,326 (0.35%) were diagnosed with AF. The higher areca nut chewing rate, the higher prevalence rate of AF in Taiwan (Spearman correlation coefficient r = 0.558, p = 0.007). After adjusting for other covariates, the current areca nut chewing rate was found to be independently associated with the prevalence of AF. The adjusted odd ratio for areca nut chewing was 1.02 (95% CI = 1.00-1.04) in risk of AF prevalence.

Conclusions: Areca nut chewing is independently associated with the prevalence of AF in Taiwanese men. However, further exploration of the underlying mechanisms is necessary.

Keywords: atrial fibrillation, areca nut chewing.

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Tsai WC, Chen CY, Kuo HF, Wu MT, Tang WH, Chu CS, Lin TH, Su HM, Hsu PC, Jhuo SJ, Lin MY, Lee KT, Sheu SH, Lai WT. Areca Nut Chewing and Risk of Atrial Fibrillation in Taiwanese Men: A Nationwide Ecological Study. Int J Med Sci 2013; 10(7):804-811. doi:10.7150/ijms.5998. Available from http://www.medsci.org/v10p0804.htm