BACKGROUND Alcohol consumption is a known modifiable risk factor for atrial fibrillation.The association,however,might differ according to gender.We investigated gender-specific associations between alcohol consumptio...BACKGROUND Alcohol consumption is a known modifiable risk factor for atrial fibrillation.The association,however,might differ according to gender.We investigated gender-specific associations between alcohol consumption and incident atrial fibrillation in an elderly Chinese population.METHODS Our study participants were elderly residents(≥65 years)recruited from five community health centers in the urban area of Shanghai(n=6,618).Alcohol intake was classified as never drinkers and current light-to-moderate(<40 g/day)and heavy drinkers(≥40 g/day).Atrial fibrillation was detected by a 30-s single-lead electrocardiography(ECG,AliveCor®Heart Monitor)and further evaluated with a regular 12-lead ECG.RESULTS During a median of 2.1 years(interquartile range:2.0−2.2)follow-up,the incidence rate of atrial fibrillation was 1.10%in all study participants.It was slightly but non-significantly higher in men(n=2849)than women(n=3769,1.30%vs.0.96%,P=0.19)and in current drinkers(n=793)than never drinkers(n=5825,1.64%vs.1.03%,P=0.12).In both unadjusted and adjusted analyses,there was interaction between sex and current alcohol intake in relation to the incidence of atrial fibrillation(P<0.0001).After adjustment for confounding factors,current drinkers had a significantly higher incidence rate of atrial fibrillation than never drinkers in women(12.96%[7/54]vs.0.78%[29/3715],adjusted odds ratio[OR]=10.25,95%confidence interval[CI]:3.54−29.67,P<0.0001),but not in men(0.81%[6/739]vs.1.47%[31/2110],OR=0.62,95%CI:0.25−1.51,P=0.29).CONCLUSIONS Our study showed a significant association between alcohol intake and the incidence of atrial fibrillation in elderly Chinese women,but not men.展开更多
BACKGROUND Atrial fibrillation(AF)is a common cardiac arrhythmia in the elderly.This study aimed to evaluate urban-rural disparities in its prevalence and management in elderly Chinese.METHODS Consecutive participants...BACKGROUND Atrial fibrillation(AF)is a common cardiac arrhythmia in the elderly.This study aimed to evaluate urban-rural disparities in its prevalence and management in elderly Chinese.METHODS Consecutive participants aged≥65 years attending outpatient clinics were enrolled for AF screening using handheld single-lead electrocardiogram(ECG)from April 2017 to December 2022.Each ECG rhythm strip was reviewed from the research team.AF or uninterpretable single-lead ECGs were referred for 12-lead ECG.Primary study outcome comparison was between rural and urban areas for the prevalence of AF.The Student’s t-test was used to compare mean values of clinical characteristics 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 characteristics.RESULTS The 29,166 study participants included 13,253 men(45.4%)and had a mean age of 72.2 years.The 7073 rural participants differed significantly(P≤0.02)from the 22,093 urban participants in several major characteristics,such as older age,greater body mass index,and so on.The overall prevalence of AF was 4.6%(n=1347).AF was more prevalent in 7073 rural participants than 22,093 urban participants(5.6%vs.4.3%,P<0.01),before and after adjustment for age,body mass index,blood pressure,pulse rate,cigarette smoking,alcohol consumption and prior medical history.Multivariate logistic regression analysis identified 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 alcohol 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 management in rural areas than urban areas.Our study findings provide insight for health policymakers to consider urban-rural disparity in the prevention and treatment of AF.展开更多
文摘BACKGROUND Alcohol consumption is a known modifiable risk factor for atrial fibrillation.The association,however,might differ according to gender.We investigated gender-specific associations between alcohol consumption and incident atrial fibrillation in an elderly Chinese population.METHODS Our study participants were elderly residents(≥65 years)recruited from five community health centers in the urban area of Shanghai(n=6,618).Alcohol intake was classified as never drinkers and current light-to-moderate(<40 g/day)and heavy drinkers(≥40 g/day).Atrial fibrillation was detected by a 30-s single-lead electrocardiography(ECG,AliveCor®Heart Monitor)and further evaluated with a regular 12-lead ECG.RESULTS During a median of 2.1 years(interquartile range:2.0−2.2)follow-up,the incidence rate of atrial fibrillation was 1.10%in all study participants.It was slightly but non-significantly higher in men(n=2849)than women(n=3769,1.30%vs.0.96%,P=0.19)and in current drinkers(n=793)than never drinkers(n=5825,1.64%vs.1.03%,P=0.12).In both unadjusted and adjusted analyses,there was interaction between sex and current alcohol intake in relation to the incidence of atrial fibrillation(P<0.0001).After adjustment for confounding factors,current drinkers had a significantly higher incidence rate of atrial fibrillation than never drinkers in women(12.96%[7/54]vs.0.78%[29/3715],adjusted odds ratio[OR]=10.25,95%confidence interval[CI]:3.54−29.67,P<0.0001),but not in men(0.81%[6/739]vs.1.47%[31/2110],OR=0.62,95%CI:0.25−1.51,P=0.29).CONCLUSIONS Our study showed a significant association between alcohol intake and the incidence of atrial fibrillation in elderly Chinese women,but not men.
基金supported by the National Natural Science Foundation of China(No.82070432&No.82070435&No.82270469&No.82370426)the Ministry of Science and Technology,Beijing,China(2018YFC1704902&2022YFC3601302)+2 种基金the Shanghai Commissions of Science and Technology and Health(a special grant for“leading academics”)(No.19DZ2340200)the Three-year Action Program of Shanghai Municipality for Strengthening the Construction of Public Health System Big Data and Artificial Intelligence Application,Shanghai,China(GWV-10.1-XK05)the Clinical Research Program,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine(2018CR010),Shanghai,China.
文摘BACKGROUND Atrial fibrillation(AF)is a common cardiac arrhythmia in the elderly.This study aimed to evaluate urban-rural disparities in its prevalence and management in elderly Chinese.METHODS Consecutive participants aged≥65 years attending outpatient clinics were enrolled for AF screening using handheld single-lead electrocardiogram(ECG)from April 2017 to December 2022.Each ECG rhythm strip was reviewed from the research team.AF or uninterpretable single-lead ECGs were referred for 12-lead ECG.Primary study outcome comparison was between rural and urban areas for the prevalence of AF.The Student’s t-test was used to compare mean values of clinical characteristics 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 characteristics.RESULTS The 29,166 study participants included 13,253 men(45.4%)and had a mean age of 72.2 years.The 7073 rural participants differed significantly(P≤0.02)from the 22,093 urban participants in several major characteristics,such as older age,greater body mass index,and so on.The overall prevalence of AF was 4.6%(n=1347).AF was more prevalent in 7073 rural participants than 22,093 urban participants(5.6%vs.4.3%,P<0.01),before and after adjustment for age,body mass index,blood pressure,pulse rate,cigarette smoking,alcohol consumption and prior medical history.Multivariate logistic regression analysis identified 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 alcohol 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 management in rural areas than urban areas.Our study findings provide insight for health policymakers to consider urban-rural disparity in the prevention and treatment of AF.
