1st Clinical Department of Cardiology, Swietokrzyskie Centre of Cardiology, Kielce.
Kardiol Pol. 2013;71(4):352-8. doi: 10.5603/KP.2013.0062.
Hypertension, due to its prevalence, is a common and independent risk factor for atrial fibrillation (AF). High blood pressure causes structural and functional changes in the myocardium, leading to an increased risk of arrhythmia. This risk is higher when hypertension is accompanied by concomitant diseases that contribute to the development of AF.
To estimate prevalence of AF and predisposing factors for AF in patients with hypertension hospitalised in our cardiology unit.
This retrospective analysis included 4459 patients hospitalised in the Clinical Department of Cardiology in 2009-2010. Hypertension was identified in 2512 (56.3%) patients. The study group consisted of 685 (27.3%) patients with hypertension and concomitant AF, and the control group included 1827 (63.7%) hypertensive patients without AF. We analysed clinical data including AF type, coexisting diseases and left ventricular ejection fraction evaluated by echocardiography.
Mean patient age in the study group was 74 years compared to 67 years in the control group. Most patients in the study group had either paroxysmal (46%) or permanent AF (45.5%). The following rates of coexisting diseases were found in the study and control groups: heart failure (HF) 54.3% vs. 31.4%, respectively (p < 0.001), ischaemic heart disease (IHD) 44.4% vs. 25.2% (p < 0.001), diabetes 28.3% vs. 24.2% (p = 0.126), hypercholesterolaemia 25.4% vs. 30.4% (p = 0.067), stroke 10% vs. 3% (p = 0.0028), hyperthyroidism 4.7% vs. 1.9% (p = 0.0002), hypothyroidism 5.1% vs. 2.1% (p = 0.0001), and euthyroid goitre 5.3% vs. 2.1% (p < 0.0001). Multivariate logistic regression analysis identified the following factors that significantly affected the occurrence of AF in patients with hypertension: hypothyroidism (hazard ratio [HR] 3.27), IHD (HR 2.75), hyperthyroidism (HR 2.55), euthyroid goitre (HR 2.13), previous myocardial infarction (HR 1.96), and HF (HR 1.66).
Among hospitalised patients with hypertension, AF is present in a significant proportion of patients. Conditions predisposing to this arrhythmia in hypertensives include HF, IHD, thyroid diseases, and previous myocardial infarction. There was no evidence that diabetes, abnormal lipid profile, and impaired kidney function affected AF rate among patients with hypertension.
高血压因其普遍性，是房颤（AF）的常见且独立的危险因素。高血压会导致心肌结构和功能发生变化，从而增加心律失常的风险。当高血压伴有导致 AF 发生的合并症时，这种风险会更高。
评估我院心内科住院高血压患者中房颤的患病率及房颤的相关危险因素。
这是一项回顾性分析，纳入了 2009 年至 2010 年在临床心内科住院的 4459 例患者。其中 2512 例（56.3%）患者患有高血压。研究组包括 685 例（27.3%）高血压合并房颤患者，对照组包括 1827 例（63.7%）无房颤的高血压患者。我们分析了临床数据，包括房颤类型、合并症和通过超声心动图评估的左心室射血分数。
研究组患者的平均年龄为 74 岁，而对照组为 67 岁。研究组中大多数患者为阵发性（46%）或永久性房颤（45.5%）。在研究组和对照组中发现以下合并症的发生率：心力衰竭（HF）54.3%比 31.4%（p < 0.001），缺血性心脏病（IHD）44.4%比 25.2%（p < 0.001），糖尿病 28.3%比 24.2%（p = 0.126），高胆固醇血症 25.4%比 30.4%（p = 0.067），中风 10%比 3%（p = 0.0028），甲状腺功能亢进症 4.7%比 1.9%（p = 0.0002），甲状腺功能减退症 5.1%比 2.1%（p = 0.0001），和正常甲状腺功能的甲状腺肿 5.3%比 2.1%（p < 0.0001）。多变量逻辑回归分析确定了以下显著影响高血压患者房颤发生的因素：甲状腺功能减退症（危险比 [HR] 3.27）、IHD（HR 2.75）、甲状腺功能亢进症（HR 2.55）、正常甲状腺功能的甲状腺肿（HR 2.13）、既往心肌梗死（HR 1.96）和心力衰竭（HR 1.66）。
在住院的高血压患者中，房颤在很大一部分患者中存在。导致高血压患者发生这种心律失常的情况包括心力衰竭、缺血性心脏病、甲状腺疾病和既往心肌梗死。没有证据表明糖尿病、血脂异常和肾功能不全会影响高血压患者的房颤发生率。
