The U.S. is now suffering from what the medical community is referring to as an obesity epidemic and doctors across the country are seeing the negative health effects of rising weight. A new study this month has shown yet another metric by which Americans’ heart health could be getting even worse.

The study, published in the American Heart Association journal Circulation, shows that atrial fibrillation is on the rise in the U.S. Atrial fibrillation refers to an irregular heartbeat and can greatly increase the risk of stroke.

The study’s authors poured over 4 million hospitalization records from 2001 to 2010. They found that hospitalizations for atrial fibrillation rose 23% during that time. Hospitalizations rose even more significantly for people over the age of 65. The Southern U.S. had the highest percentage of hospitalizations for the condition at 38%.

“Atrial fibrillation is a disease in itself, but it also serves as a marker for the severity of other illnesses,” said Dr. Nileshkumar Patel, lead author of the study and a doctor at Staten Island University Hospital.

Patel and his colleagues noted a 400% rise in kidney failure accompanying atrial fibrillation over the study period. They also found that deaths from the condition fell over the decade, but also saw the cost of hospitalization for atrial fibrillation rise 24%.

The study’s authors believe this rise in hospitalizations can be attributed to the aging population of the U.S., as well as rising cases of obesity, diabetes, high blood pressure, and sleep apnea. The study warns that a rise in atrial fibrillation cases may become a “major burden” on U.S. hospitals and urges outpatient and preventative care to treat the condition.

“We must treat atrial fibrillation and its risk factors better in the outpatient setting to prevent hospitalizations and reduce its staggering impact,” said Dr. Abhishek Deshmukh, a co-author of the study and a cardiologist at the University of Arkansas for Medical Sciences.

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