Atrial Fibrillation: Prevention Is Possible

Atrial fibrillation (AF) is an increasing public health challenge — but prevention is absolutely possible.

Good control of blood pressure, body weight, blood sugar, and alcohol intake, along with appropriate management of heart failure and diabetes, can significantly reduce the risk of developing AF and its serious complications.

Much has been written about what atrial fibrillation is and how it is treated. But far too little attention is given to how it can actually be prevented in the first place.

AF is not merely a “rhythm problem.” It represents a major health burden in the Western world. The lifetime risk of developing AF is estimated to be as high as 30–40% among individuals of European descent. In Denmark, the lifetime risk has increased from 24% to 31% over the past two decades.

The consequences are serious

People with AF have a 1.5–2 times higher risk of premature death compared to those without it. Among individuals under 50, AF shortens life expectancy by about 9 years on average. For those under 60, the loss is around 7.4 years.

Symptoms like palpitations, fatigue, and shortness of breath significantly reduce quality of life, and AF also increases the risk of stroke and heart failure. The impact is greatest for those diagnosed at a young age, with studies showing a 9–11 year reduction in life expectancy when AF occurs before age 50. In older patients, the gap is smaller but still clear.

People with atrial fibrillation (red) have a shorter average life expectancy compared to those without atrial fibrillation (blue)

This underlines the importance of preventing atrial fibrillation and detecting it early, to slow disease progression and reduce complications.

(Source: Paludan-Müller et al., European Heart Journal, 2024 – “Atrial fibrillation: age at diagnosis, incident cardiovascular events, and mortality”)

Prevention Must Be Central to Public Health

There’s no doubt: preventing atrial fibrillation should be a key public health priority. Identifying and following up with individuals at risk of AF can make a substantial difference, both for individuals and for society as a whole.

Six Key Steps to Prevent Atrial Fibrillation

The latest European Society of Cardiology (ESC 2024) guidelines emphasize that AF prevention starts with taking care of the body before the arrhythmia takes hold. Here are six measures that truly matter:

1️⃣ Keep your blood pressure under control

High blood pressure is the strongest risk factor for AF. It makes the heart work harder and causes the atria to enlarge, a major trigger for atrial fibrillation. Stable, well-controlled blood pressure greatly reduces risk. Lifestyle adjustments and appropriate medication are the foundation.

2️⃣ Treat heart failure properly

If you have heart failure, optimal medical therapy is essential. Drugs such as ACE inhibitors (Ramipril, Enalapril), ARBs (Valsartan, Candesartan), and SGLT2 inhibitors (Empagliflozin, Dapagliflozin) can actually reduce the risk of developing AF. The better your heart works, the lower your risk of rhythm disturbances.

3️⃣ Keep your blood sugar stable

Type 2 diabetes increases the risk of AF, but good glycemic control can reverse this trend. High insulin levels in diabetes cause structural and functional changes in the atria that impair normal electrical conduction and promote arrhythmias. Balanced nutrition, regular activity, and SGLT2 inhibitors help protect the heart.

4️⃣ Avoid overweight

Excess weight is a strong risk factor for AF. Studies show that those who lose weight have a significantly lower risk, even with modest weight-loss. Maintaining a healthy BMI gives your heart the best working conditions.

5️⃣ Stay physically active — in moderation

Regular, moderate exercise as recommended by health authorities strengthens the heart and reduces AF risk. However, years of extreme endurance training may actually increase the risk. The key is finding the golden mean.

6️⃣ Limit alcohol consumption

Alcohol is strongly linked to atrial fibrillation, and risk increases with the amount consumed. People who stop drinking have a markedly lower incidence of AF than those who continue heavy drinking. Reducing alcohol intake, especially avoiding binge episodes during weekends or parties, is a simple and effective way to prevent AF.

In Summary

Preventing atrial fibrillation isn’t about one single action — it’s about maintaining a heart-healthy lifestyle over time.

• ✔️ Keep blood pressure under control

• ✔️ Treat heart failure and diabetes properly

• ✔️ Maintain a healthy weight

• ✔️ Stay moderately active

• ✔️ Limit alcohol intake

  
  

Small, consistent steps can make a big difference for your heart rhythm — and your future health.