Soliman Elsayed Z, Prineas Ronald J
Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC, USA; Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, NC, USA.
Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest School of Medicine, Winston Salem, NC, USA.
J Electrocardiol. 2014 Nov-Dec;47(6):804-8. doi: 10.1016/j.jelectrocard.2014.07.010. Epub 2014 Jul 18.
The reported lower prevalence and incidence of atrial fibrillation (AF) despite the higher prevalence of AF risk factors in African Americans compared to Caucasian whites has been referred to as the paradox of AF in African Americans. In this report we highlight this paradox and address potential explanations using data from several US populations studies. These possible explanations include limited methodology to detect AF patterns that are harder to detect (e.g. paroxysmal/intermittent AF or atrial flutter) coupled with the possibility of African Americans having more of these patterns, differential access to health care with African Americans having less access and subsequently less detected AF, survival bias with Caucasian whites living longer and subsequently having more AF, and finally differential impact of AF risk factors with Caucasian whites being more affected or African Americans less affected by AF risk factors whether this is genetically determined or via other unknown predispositions.
与白种人相比，尽管非裔美国人中房颤（AF）危险因素的患病率更高，但报告显示其房颤的患病率和发病率较低，这一现象被称为非裔美国人房颤悖论。在本报告中，我们强调了这一悖论，并利用来自美国多项人群研究的数据探讨了可能的解释。这些可能的解释包括：检测较难发现的房颤类型（如阵发性/间歇性房颤或心房扑动）的方法有限，同时非裔美国人中这类类型可能更多；获得医疗保健的机会存在差异，非裔美国人获得的机会较少，因此检测到的房颤也较少；生存偏差，白种人寿命更长，因此房颤更多；最后是房颤危险因素的差异影响，白种人受房颤危险因素的影响更大，或者非裔美国人受其影响较小，无论这是由基因决定的，还是通过其他未知的易患因素导致的。
