Du Xin, Guo Lizhu, Xia Shijun, Du Jing, Anderson Craig, Arima Hisatomi, Huffman Mark, Yuan Yiqiang, Zheng Yang, Wu Shulin, Guang Xuefeng, Zhou Xianhui, Lin Hongbo, Cheng Xiaoshu, Dong Jianzeng, Ma Changsheng
Beijing Anzhen Hospital, Capital Medical University, National Clinical Research Center for Cardiovascular Diseases, Beijing, China.
Heart Health Research Centre, Beijing, China.
Heart. 2021 Jan 28;107(7):535-41. doi: 10.1136/heartjnl-2020-317915.
To determine AF prevalence and gaps in atrial fibrillation (AF) awareness and management in China.
We conducted a community-based survey of 47 841 adults (age ≥45 years) in seven geographic regions of China between 2014 and 2016. Participants underwent a structured questionnaire, a standard 12-lead ECG, physical examination and blood sampling. AF prevalence, defined by either ECG detection or self-report, was estimated according to sampling weights, non-response and age and sex distribution of the population. We used multivariable logistic regression to estimate associations among sociodemographic, clinical and geographic factors with the AF prevalence, awareness and treatment.
The weighted AF prevalence was 1.8% (95% CI 1.7% to 1.9%), but varied from 0.9% to 2.4% across geographical regions and equates to being present in an estimated 7.9 (95% CI 7.4 to 8.4) million people in China. Among men and women, the AF prevalence increased from 0.8% and 0.6% in the age group 45-54 years to 5.4% and 4.9% in the age group ≥75 years, respectively. Proportions of people who were aware of having AF decreased overall from 65.3% in 45-54 year-olds to 53.9% in ≥75 year-olds and varied between sex (men 58.5%, women 68.8%) and residency status (urban 78.3%, rural 35.3%). Only 6.0% of patients with high-risk AF received anticoagulation therapy.
AF prevalence is higher than previously reported in China, with low awareness and large treatment gaps. Large-scale efforts are urgently needed to reduce AF adverse consequences.
确定中国心房颤动（AF）的患病率以及在房颤认知和管理方面的差距。
2014年至2016年期间，我们在中国七个地理区域对47841名成年人（年龄≥45岁）进行了一项基于社区的调查。参与者接受了结构化问卷调查、标准12导联心电图检查、体格检查和血液采样。根据抽样权重、无应答情况以及人群的年龄和性别分布，估算通过心电图检测或自我报告定义的房颤患病率。我们使用多变量逻辑回归来估计社会人口统计学、临床和地理因素与房颤患病率、认知率和治疗之间的关联。
加权房颤患病率为1.8%（95%置信区间1.7%至1.9%），但各地理区域患病率在0.9%至2.4%之间有所不同，相当于中国约790万（95%置信区间740万至840万）人患有房颤。在男性和女性中，房颤患病率分别从45 - 54岁年龄组的0.8%和0.6%增加到75岁及以上年龄组的5.4%和4.9%。知晓自己患有房颤的人群比例总体上从45 - 54岁人群的65.3%下降到75岁及以上人群的53.9%，并且在性别（男性58.5%，女性68.8%）和居住状况（城市78.3%，农村35.3%）方面存在差异。只有6.0%的高危房颤患者接受了抗凝治疗。
中国房颤患病率高于先前报道，认知率低且治疗差距大。迫切需要开展大规模努力以减少房颤的不良后果。
