Abstract: Objective To investigate the distribution of the HARMS2-AF score within a general population cohort in Southern China and to identify the factors associated with this risk score. Methods Data were sourced from the baseline information (2018-2020) of the prospective cohort study on chronic non-communicable diseases in a general population of Southern China. A total of 53, 826 permanent residents from the survey sites were included as the study population. Data pertaining to demographic characteristics, lifestyle factors, and physical examinations were collected. The distribution of the HARMS2-AF score was analyzed for the entire cohort and across various subgroups, and its associated factors were subsequently explored. Results The HARMS2-AF scores within the Southern China general population cohort ranged from 0 to 12. The distribution was as follows: 24.5% of participants were in the first group (score of 0), 18.7% in the second group (scores 1-2), 28.1% in the third group (scores 3-5), and 28.7% in the fourth group (scores 6-12). Multivariate analysis indicated that an alternative marital status [Prevalence Ratio (PR)=1.39, 95% CI: 1.35-1.43)], moderate socioeconomic status (PR=1.25, 95% CI: 1.21-1.28), low socioeconomic status (PR=1.49, 95% CI: 1.44-1.54), sleep disorders (PR=1.08, 95% CI: 1.06-1.11), obesity (PR=1.57, 95% CI: 1.53-1.61), diabetes mellitus (PR=1.60, 95% CI: 1.56-1.65), and cardiovascular disease (PR=1.69, 95% CI: 1.63-1.75) were all associated with an increased risk of a high HARMS2-AF score. Conversely, individuals with low or high levels of physical activity exhibited a significantly lower risk of a high score compared to those with moderate activity levels (PR=0.93, 95% CI: 0.91-0.96 and PR=0.95, 95% CI: 0.92-0.97, respectively). Conclusions The overall HARMS2-AF scores in the general population of Southern China are relatively low. Public health interventions should prioritize high-risk populations, particularly individuals with low socioeconomic status and chronic diseases. The adoption of healthy lifestyle habits is crucial for mitigating the risk of atrial fibrillation.

Key words: HARMS₂-AF, Atrial fibrillation, Lifestyle modification, Cardiovascular disease