Exploring urban versus rural disparities in atrial fibrillation:pr-evalence and management trends among elderly Chinese in a screening study
Wei ZHANG1
Yi CHEN1
Lei-Xiao HU1
Jia-Hui XIA1
Xiao-Fei YE1
Wen-Yuan-Yue WANG1
Xin-Yu WANG1
Quan-Yong XIANG2
Qin TAN3
Xiao-Long WANG4
Xiao-Min YANG5
De-Chao ZHAO6
Xin CHEN1
Yan LI1
Ji-Guang WANG7
for the IMPRESSION Investigators and Coordinators
1.Department of Cardiovascular Medicine,Centre for Epidemiological Studies and Clinical Trials,Shanghai Key Labor-atory of Hypertension,The Shanghai Institute of Hypertension,Department of Hypertension,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China2.Department of Chronic Non-communicable Disease Con-trol,Jiangsu Province Center for Disease Control and Prevention,Nanjing,China3.Shanghai Pudong New Area Sa-nlinkangde Community Health Center,Shanghai,China4.Department of Cardiology,People's Hospital of Hongsibao District,Ningxia,China5.General Medicine,Sir Run Run Shaw Hospital,Zhejiang University,Zhejiang,China6.De-partment of Cardiology,First Affiliated Hospital of Harbin Medical University,Harbin,China7.Department of Cardiovascular Medicine,Centre for Epidemiological Studies and Clinical Trials,Shanghai Key Labor-atory of Hypertension,The Shanghai Institute of Hypertension,Department of Hypertension,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China;National Research Ce-ntre for Translational Medicine at Shanghai,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shang-hai,China
摘要：BACKGROUND Atrial fibrillation(AF)is a common cardiac arrhythmia in the elderly.This study aimed to evaluate urban-ru-ral disparities in its prevalence and management in elderly Chinese.
METHODS Consecutive participants aged ≥ 65 years attending outpatient clinics were enrolled for AF screening using hand-held single-lead electrocardiogram(ECG)from April 2017 to December 2022.Each ECG rhythm strip was reviewed from the res-earch team.AF or uninterpretable single-lead ECGs were referred for 12-lead ECG.Primary study outcome comparison was bet-ween rural and urban areas for the prevalence of AF.The Student's t-test was used to compare mean values of clinical characteri-stics between rural and urban participants,while the Pearson's chi-square test was used to compare between-group proportions.Multivariate stepwise logistic regression analysis was performed to estimate the association between AF and various patient char-acteristics.
RESULTS The 29,166 study participants included 13,253 men(45.4％)and had a mean age of 72.2 years.The 7073 rural parti-cipants differed significantly(P ≤ 0.02)from the 22,093 urban participants in several major characteristics,such as older age,grea-ter body mass index,and so on.The overall prevalence of AF was 4.6％(n=1347).AF was more prevalent in 7073 rural partici-pants than 22,093 urban participants(5.6％vs.4.3％,P＜0.01),before and after adjustment for age,body mass index,blood pressu-re,pulse rate,cigarette smoking,alcohol consumption and prior medical history.Multivariate logistic regression analysis identif-ied overweight/obesity(OR=1.35,95％CI:1.17-1.54)in urban areas and cigarette smoking(OR=1.62,95％CI:1.20-2.17)and alco-hol consumption(OR=1.42,95％CI:1.04-1.93)in rural areas as specific risk factors for prevalent AF.In patients with known AF in urban areas(n=781)and rural areas(n=338),60.6％and 45.9％,respectively,received AF treatment(P＜0.01),and only 22.4％and 17.2％,respectively,received anticoagulation therapy(P=0.05).
CONCLUSIONS In China,there are urban-rural disparities in AF in the elderly,with a higher prevalence and worse manage-ment in rural areas than urban areas.Our study findings provide insight for health policymakers to consider urban-rural dispari-ty in the prevention and treatment of AF.
机标关键词：managementchinesescreeningruralstudyamongatrialdisparities
论文发表日期：2025-02-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 246-254 )