Kannel W B, Abbott R D, Savage D D, McNamara P M
N Engl J Med. 1982 Apr 29;306(17):1018-22. doi: 10.1056/NEJM198204293061703.
In the Framingham Study 2325 men and 2866 women 30 to 62 years old at entry were followed biennially over 22 years for the development of chronic atrial fibrillation in relation to antecedent cardiovascular disease and risk factors. During surveillance, atrial fibrillation developed in 49 men and 49 women. The incidence rose sharply with age but did not differ significantly between the sexes. Overall, there was a 2.0 per cent chance that the disorder would develop in two decades. Atrial fibrillation usually followed the development of overt cardiovascular disease. Only 18 men and 12 women (31 per cent) had chronic atrial fibrillation in the absence of cardiovascular disease. Cardiac failure and rheumatic heart disease were the most powerful predictive precursors, with relative risks in excess of sixfold. Hypertensive cardiovascular disease was the most common antecedent disease, largely because of its frequency in the general population. Among the risk factors for cardiovascular disease, diabetes and electrocardiographic evidence of left ventricular hypertrophy were related to the occurrence of atrial fibrillation. The development of chronic atrial fibrillation was associated with a doubling of overall mortality and of mortality from cardiovascular disease.
在弗明汉姆研究中，对入组时年龄在30至62岁的2325名男性和2866名女性进行了为期22年的随访，每两年进行一次，以观察慢性房颤的发生与既往心血管疾病及危险因素之间的关系。在监测期间，49名男性和49名女性发生了房颤。发病率随年龄急剧上升，但两性之间无显著差异。总体而言，在二十年内发生这种疾病的几率为2.0%。房颤通常在明显的心血管疾病发生之后出现。只有18名男性和12名女性（31%）在无心血管疾病的情况下患有慢性房颤。心力衰竭和风湿性心脏病是最有力的预测先兆，相对风险超过六倍。高血压性心血管疾病是最常见的既往疾病，主要是因为其在普通人群中的发病率较高。在心血管疾病的危险因素中，糖尿病和左心室肥厚的心电图证据与房颤的发生有关。慢性房颤的发生与总死亡率和心血管疾病死亡率的加倍有关。
