Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jul 28:9:955685.
doi: 10.3389/fcvm.2022.955685. eCollection 2022.

Epidemiology of atrial fibrillation and risk of CVD mortality among hypertensive population: A prospective cohort study in Northeast China

Zhi Du  1 , Min Lin  2 , Yuanmeng Tian  3   4 , Li Jing  3   4 , Shuang Liu  5 , Guangxiao Li  6 , Tong Jia  7 , Qun Sun  8 , Lei Shi  9 , Jixu Sun  10 , Wen Tian  11 , Liying Xing  3   4
Affiliations

Epidemiology of atrial fibrillation and risk of CVD mortality among hypertensive population: A prospective cohort study in Northeast China

Zhi Du et al. Front Cardiovasc Med. .

Abstract

Background: Determining risk factors of cardiovascular disease (CVD)-related mortality and evaluating their influence are important for effectively reducing corresponding mortality. However, few research findings have estimated the relationship between atrial fibrillation (AF) and CVD-related mortality among hypertension individuals.

Objective: The objective of this study was to investigate the epidemiology of AF in a hypertension population and determine the relationship between AF and CVD-related mortality.

Methods: Using a multistage, stratified, and cluster random sampling method, the prospective cohort study with a median follow-up of 3.51 years enrolled 10,678 hypertensive participants at baseline. The prevalence, awareness, and anticoagulation data of AF in this focal population were carefully assessed. Stepwise logistic regression and Cox regression analysis were respectively performed to evaluate the determinants of AF and the association between AF and CVD-related mortality.

Results: The overall prevalence of AF was 1.3% (95% CI, 1.1%-1.6%) in the hypertensive population, and it was higher in men than in women (1.8% vs. 1.0%, respectively; p=0.001). The awareness of AF was 53.1%, and the rate of oral anticoagulant (OAC) therapy was only 4.2%, although all AF participants should have required according to the European Society of Cardiology guidelines. The determinants of AF included elder, male, and history of coronary heart disease in the hypertensive population. Besides, compared with individuals without AF, the risk of CVD-related mortality significantly increased in the hypertensive population with AF (HR 3.37, 95% CI 2.10-5.40).

Conclusion: Our results indicated a huge burden of AF and underuse of OAC therapy for them in a community-based hypertensive population. Considering that most of the risk factors of AF were unmodifiable in hypertensive individuals, as well as its high risk of mortality, long-term interventions including AF education, timely screening, and widespread use of OACs should be emphasized in the focal populations.

Keywords: CVD mortality; atrial fibrillation; epidemiology; oral anticoagulant therapy; risk factor.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
The CHA2DS2-VASc score in hypertensive population with atrial fibrillation.
Figure 2
Figure 2
The awareness (A) and oral anticoagulant (OAC) usage (B) of AF among hypertensive patients.
Figure 3
Figure 3
The Kaplan-Meier curves comparing the incidence of CVD mortality between hypertensive patients with AF and without AF.
Figure 4
Figure 4
The Cox proportional hazards regression analysis exploring the association between AF and the hazard ratio of subsequent CVD mortality.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. . 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. (2016) 37:2893–962. 10.1093/eurheartj/ehw210 - DOI - PubMed
    1. Pastori D, Menichelli D, Del Sole F, Pignatelli P, Violi F. Long-term risk of major adverse cardiac events in atrial fibrillation patients on direct oral anticoagulants. Mayo Clin Proc. (2021) 96:658–65. 10.1016/j.mayocp.2020.06.057 - DOI - PubMed
    1. Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. . Global, regional, and national burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol. (2017) 70:1–25. 10.1016/j.jacc.2017.04.052 - DOI - PMC - PubMed
    1. Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, et al. . Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. (2014) 129:837–47. 10.1161/CIRCULATIONAHA.113.005119 - DOI - PMC - PubMed
    1. Rahman F, Kwan GF, Benjamin EJ. Global epidemiology of atrial fibrillation. Nat Rev Cardiol. (2014) 11:639–54. 10.1038/nrcardio.2014.118 - DOI - PubMed

LinkOut - more resources