An epidemiological study on the prevalence of atrial fibrillation in the Chinese population of mainland China

Ziqiang Zhou, Dayi Hu, Ziqiang Zhou, Dayi Hu

Abstract

Background: Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Since only limited data on the Chinese population, which is the largest in the world, is available, we conducted an epidemiological study on the prevalence and risk factors of AF in mainland China.

Methods: This population-based study conducted by cluster sampling comprised 29079 participants forming 14 cohorts from 13 provinces across China, where the population was nearly 1 billion. Every participant underwent electrocardiogram and physical examinations and responded to the interviewer-led questionnaire(s). Univariate and multiple statistical analyses were conducted to explore the relationship between AF prevalence and risk factors.

Results: The age-standardized prevalence of AF in China (>or=30 y) was 0.65%, and it increased with age. Men showed a higher prevalence of AF than women (0.91% [age-standardized, 0.66%] vs. 0.65% [0.63%], P = 0.013); several significant risk factors (age, hyperthyroidism, coronary heart disease, and rheumatic heart disease) were identified for AF in the general population. Stroke prevalence was much higher in AF patients than in non-AF people (12.95% vs. 2.28%, P < 0.001). AF was confirmed to be a significant independent risk factor for stroke prevalence in the studied population (OR = 2.776, [1.814, 4.248], P < 0.001). We found that AF patients received poor treatment (2.7%, warfarin; 39.7%, aspirin).

Discussion: This study conducted on a large sample size demonstrates that AF prevalence in mainland China is slightly lower than that in Western countries and similar to that in Asian areas, and confirms that AF is a serious public health problem in China. We identified several potential risk factors, but their associations with AF still need to be further studied.

Figures

https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4771592/bin/je-18-209-g001.jpg

References

    1. Schneider EL, Guralnik JM. The aging of America. Impact on health care costs. JAMA 1990;263:2335-2340. 10.1001/jama.1990.03440170057036
    1. Stewart S, Murphy N, Walker A, McGuire A, McMurray JJ. Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK. Heart 2004;90:286-92. 10.1136/hrt.2002.008748
    1. Majeed A, Moser K, Carroll K. Trends in the prevalence and management of atrial fibrillation in general practice in England and Wales, 1994-1998: analysis of data from the general practice research database. Heart 2001;86:284-288. 10.1136/heart.86.3.284
    1. Stewart S, MacIntyre K, Boyd J, Finlayson A, Redpath A, Pell JP, et al. . Trends in first-ever admissions for atrial fibrillation in Scotland: 1985-1995. Int J Cardiol 2002;82:229-236. 10.1016/S0167-5273(01)00626-X
    1. Wolf PA, Benjamin EJ, Belanger AJ, Kannel WB, Levy D, D’Agostino RB. Secular trends in the prevalence of atrial fibrillation: The Framingham Study. Am Heart J 1996;131:790-795. 10.1016/S0002-8703(96)90288-4
    1. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: The Framingham Study. Stroke 1991;22:983-988. 10.1161/01.STR.22.8.983
    1. Feinberg WM, Blackshear JL, Laupacis A, Kronmal R, Hart RG. Prevalence, age distribution, and gender of patients with atrial fibrillation: analysis and implications. Arch Intern Med 1995;155:469-473. 10.1001/archinte.1995.00430050045005
    1. Go AS, Hylek EM, Phillips KA, Chang YC, Henault LE, Selby JV, et al. . Prevalence of diagnosed atrial fibrillation in adults. JAMA 2001;285:2370-5. 10.1001/jama.285.18.2370
    1. Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol 1998;82:2N-9N. 10.1016/S0002-9149(98)00583-9
    1. Ruo B, Capra AM, Jensvold NG, Go AS. Racial variation in the prevalence of atrial fibrillation among patients with heart failure: the Epidemiology, Practice, Outcomes, and Costs of Heart Failure (EPOCH) Study. J Am Coll Cardiol 2004;43:429-3. 10.1016/j.jacc.2003.09.035
    1. Ohsawa M, Okayama A, Sakata K, Kato K, Itai K, Onoda T, et al. . Rapid increase in estimated number of persons with atrial fibrillation in Japan: an analysis from national surveys on cardiovascular diseases in 1980, 1990 and 2000. J Epidemiol 2005. Sep;15(5):194-6. 10.2188/jea.15.194
    1. Nakayama T, Date C, Yokoyama T, Yoshiike N, Yamaguchi M, Tanaka H. A 15.5 year follow-up study of stroke in a Japanese provincial city. Stroke 1997; 28:45-52. 10.1161/01.STR.28.1.45
    1. Yap KB, Ng TP, Ong HY. Low prevalence of atrial fibrillation in community-dwelling Chinese aged 55 years or older in Singapore: a population-based study. J Electrocardiol 2008;41:94-98. 10.1016/j.jelectrocard.2007.03.012
    1. Jeong HJ. Prevalence of and risk factors for atrial fibrillation in Korean adults older than 40 years. J Korean Med Sci 2005;20:26-30. 10.3346/jkms.2005.20.1.26
    1. Zhou ZQ, Hu DY, Chen J, Zhang RH, Li KB, Zhao XL. An epidemiological survey of atrial fibrillation in China. Zhonghua Nei Ke Za Zhi. 2004. Jul;43(7):491-4 (in Chinese).
    1. Minassian DC. Epidemiology in practice: sample size calculation for eye surveys: a simple method. J Comm Eye Health 1997;10(23):42-44.
    1. Weiner JS, Lourie JA, editors. Practical human biology. New York: Academic Press; 1981.
    1. Fuster V, Rydén LE, Asinger RW, Cannom DS, Crijns HJ, Frye RL, et al. . ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients with Atrial Fibrillation): developed in Collaboration with the North American Society of Pacing and Electrophysiology. J Am Coll Cardiol 2001;38(4):1231-66. 10.1016/S0735-1097(01)01587-X
    1. Gallagher MM, Camm J. Classification of atrial fibrillation. Am J Cardiol 1998;82:18N-28N. 10.1016/S0002-9149(98)00736-X
    1. Newman SC, editor. Biostatistical methods in epidemiology. New York: Wiley; 2001.
    1. Nicol MB, Thrift AG. Knowledge of risk factors and warning signs of stroke. Vasc Health Risk Manag 2005;1(2):137-47. 10.2147/vhrm.1.2.137.64085
    1. Friberg J, Scharling H, Gadsboll N, Jensen GB. Sex-specific increase in the prevalence of atrial fibrillation (The Copenhagen City Heart Study). Am J Cardiol 2003; 92(12):1419-23. 10.1016/j.amjcard.2003.08.050
    1. Sudlow M, Thomson R, Thwaites B, Rodgers H, Kenny RA. Prevalence of atrial fibrillation and eligibility for anticoagulants in the community. Lancet 1998;352:1167-71. 10.1016/S0140-6736(98)01401-9
    1. Phillips SJ, Whisnant JP, O’Fallon WM, Frye RL. Prevalence of cardiovascular disease and diabetes mellitus in residents of Rochester, Minnesota. Mayo Clin Proc 1990;65:344-359. 10.1016/S0025-6196(12)62535-X
    1. Page RL, Wilkinson WE, Clair WK, McCarthy EA, Pritchett EL. Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia. Circulation 1994;89:224-227. 10.1161/01.CIR.89.1.224
    1. Patel KP. Electrocardiographic abnormalities in the sick elderly. Age Ageing 1977;6:163-167. 10.1093/ageing/6.3.163
    1. Borzecki AM, Bridgers DK, Liebschutz JM, Kader B, Kazis LE, Berlowitz DR. Racial differences in the prevalence of atrial fibrillation among males. J Natl Med Assoc 2008;100(2):237-45. 10.1016/S0027-9684(15)31212-8
    1. Benjamin EJ, Levy D, Vaziri SM, D’Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population-based cohort: The Framingham Heart Study. JAMA 1994;271:840-844. 10.1001/jama.1994.03510350050036
    1. Stewart S, Hart CL, Hole DJ, McMurray JV. Population prevalence, incidence, and predictors of atrial fibrillation in the Renfrew/Paisley study. Heart 2001;86:516-521. 10.1136/heart.86.5.516
    1. Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol 1994;74:236-241. 10.1016/0002-9149(94)90363-8
    1. Lake FR, Cullen KJ, de Klerk NH, McCall MG, Rosman DL. Atrial fibrillation and mortality in an elderly population. Aust NZ J Med 1989;19:321-326. 10.1111/j.1445-5994.1989.tb00271.x
    1. Djousse L, Levy D, Benjamin EJ, Blease SJ, Russ A, Larson MG, et al. . Long-term alcohol consumption and the risk of atrial fibrillation in the Framingham Study. Am J Cardiol 2004;93(6):710-3. 10.1016/j.amjcard.2003.12.004
    1. Bailey MS, Curtis AB. The effects of hormones on arrhythmias in women. Curr Womens Health Rep 2002;2:83-8.
    1. Qi WH. Retrospective investigation of hospitalised patients with atrial fibrillation in mainland China. Int J Cardiol 2005;105:283-287. 10.1016/j.ijcard.2004.12.042

Source: PubMed

3
구독하다