Zhang Wei, Chen Yi, Hu Lei-Xiao, Xia Jia-Hui, Ye Xiao-Fei, Wang Wen-Yuan-Yue, Wang Xin-Yu, Xiang Quan-Yong, Tan Qin, Wang Xiao-Long, Yang Xiao-Min, Zhao De-Chao, Chen Xin, Li Yan, Wang Ji-Guang
Department of Cardiovascular Medicine, Centre for Epidemiological Studies and Clinical Trials, Shanghai Key Laboratory of Hypertension, The Shanghai Institute of Hypertension, Department of Hypertension, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Chronic Non-communicable Disease Control, Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.
J Geriatr Cardiol. 2025 Feb 28;22(2):246-254. doi: 10.26599/1671-5411.2025.02.001.
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.
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 -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.
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 ( ≤ 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% ( = 1347). AF was more prevalent in 7073 rural participants than 22,093 urban participants (5.6% 4.3%, < 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 ( = 781) and rural areas ( = 338), 60.6% and 45.9%, respectively, received AF treatment ( < 0.01), and only 22.4% and 17.2%, respectively, received anticoagulation therapy ( = 0.05).
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.
心房颤动（AF）是老年人常见的心律失常。本研究旨在评估中国老年人中房颤患病率及其管理方面的城乡差异。
2017年4月至2022年12月期间，连续纳入年龄≥65岁的门诊患者，使用手持式单导联心电图（ECG）进行房颤筛查。研究团队对每一份心电图节律条进行复查。房颤或无法解读的单导联心电图被转诊进行12导联心电图检查。主要研究结果比较的是农村和城市地区房颤的患病率。采用学生t检验比较农村和城市参与者临床特征的平均值，而采用Pearson卡方检验比较组间比例。进行多因素逐步逻辑回归分析以评估房颤与各种患者特征之间的关联。
29166名研究参与者中包括13253名男性（45.4%），平均年龄为72.2岁。7073名农村参与者在几个主要特征上与22093名城市参与者有显著差异（P≤0.02），如年龄较大、体重指数较高等。房颤的总体患病率为4.6%（n = 1347）。在调整年龄、体重指数、血压、脉搏率、吸烟、饮酒和既往病史前后，7073名农村参与者中的房颤患病率高于22093名城市参与者（5.
