Global, regional, and national burden of atrial fibrillation/flutter attributable to metabolic, behavioral, and environmental risk factors, 1990–2021: a longitudinal observational study

From 1990 to 2021, high body mass index became the primary driver of the rising global AF/AFL burden, particularly affecting East Asia and young and middle-aged adults. In contrast, the burden associated with smoking showed the greatest decline. In 2021, China had the highest AF/AFL burden due to various risk factors. Given the regional variations and characteristics of high-risk populations, policymakers should develop targeted yet comprehensive prevention strategies. These measures should include promoting healthy dietary habits, strengthening global surveillance systems, and fostering data-sharing collaborations to mitigate this growing epidemic.