Abstract Body (Do not enter title and authors here): Background
Significant racial disparities exist in the prevalence of both vitamin D deficiency and atrial fibrillation (AF). Blacks demonstrate lower AF rates despite higher vitamin D deficiency prevalence compared to Whites. Vitamin D deficiency is associated with higher AF risk, and women with AF experience elevated CVA and mortality rates compared to men. Understanding the interaction between race, vitamin D status, and AF, may present a potential modifiable risk factor for AF. This study examines whether vitamin D deficiency modifies racial disparities in AF distribution between White and Black women and evaluates its impact on CVA incidence and in-hospital mortality rates.
Methods
We analyzed data from the National Inpatient Sample (2016-2020). We compared trends over the 5-year period and evaluated differences in acute stroke and in-patient mortality rates based on race and vitamin D status.
Results
Among 13.4 million hospitalizations (weighted to 67 million), AF was more common in women with vitamin D deficiency (15.6%) vs. those without (13.7%). Vitamin D deficiency was higher in Black women (2.4%) compared to White women (2.1%). White women had higher AF prevalence (15.2%) than Black women (7.8%). However, among Black women, those with vitamin D deficiency had a higher AF rate (8.95%) compared to non-deficient peers (7.74%), with an attributable risk of 13.5%. Adjusted models showed Black women without vitamin D deficiency had 53% lower odds of AF vs. White women without deficiency (OR = 0.47, p < 0.001). Black women with deficiency had similar odds to White women without deficiency (OR = 0.99, p = 0.66).
Trends plot revealed increasing AF prevalence in non-deficient women; rates in vitamin D-deficient women remained stable. In both racial groups, vitamin D deficiency was associated with higher prevalence of AF.
Regional analysis showed an overall increase in vitamin D deficiency, AF and CVA rates in both racial groups in the south compared to other regions.
Vitamin D deficient women had 18.5% increased odds of CVA. Black women with AF had 16.4% increased odds of in-hospital mortality.
Conclusion
Vitamin D deficiency is associated with increased AF prevalence in both racial groups and may attenuate the lower AF risk observed in Black women. Screening for and managing vitamin D deficiency may be a potential strategy for AF risk reduction, particularly in the Black female population. Further longitudinal studies are needed to establish causality.