Lip G Y, Bawden L, Hodson R, Rutland E, Snatchfold J, Beevers D G
University Department of Medicine, City Hospital, Birmingham, UK.
Int J Cardiol. 1998 Jul 1;65(2):187-92. doi: 10.1016/s0167-5273(98)00125-9.
Whilst there are recognised ethnic differences in cardiovascular disease, with a higher prevalence of hypertension and complications such as stroke amongst black/Afro-Caribbean populations, and ischaemic heart disease being more prevalent amongst Indo-Asians, the literature describing the clinical epidemiology of atrial fibrillation (AF) in non-caucasian groups is scarce. To survey the clinical features and management amongst Indo-Asian patients with known AF, we studied patients from six general practices in the west of Birmingham. The six general practices had a combined practice population of 25051, from which, the Indo-Asian population was 14670. A total of 12 Indo-Asian patients (six male, six female; mean age, 67 years; range, 42 to 95 years) with known AF were identified, suggesting a prevalence of AF in Indo-Asians aged >50 years of 0.6%. Six patients had chronic AF, two had recent onset (defined as onset <six months) and four had paroxysmal AF. Five patients had a history of ischaemic heart disease, three had hypertension, seven had heart failure, two had alcohol excess, four had mitral valve disease, and one patient with paroxysmal AF had sick sinus syndrome. None could be classified as having lone AF. Only four patients were anticoagulated, but, of the remaining eight, who were not taking warfarin, six were taking aspirin. None of the patients had contraindications to warfarin, but one of the patients who was taking aspirin had poor compliance to warfarin. In this survey of a general practice Indo-Asian population of approximately 14670, we found 12 patients with known AF. More information on the clinical epidemiology of AF in non-caucasian groups is still needed and urgently required, in view of the public health implications of this common cardiac arrhythmia.
虽然心血管疾病存在公认的种族差异,黑人/非裔加勒比人群中高血压和中风等并发症的患病率较高,而缺血性心脏病在印度裔亚洲人群中更为普遍,但描述非白种人群中心房颤动(AF)临床流行病学的文献却很匮乏。为了调查已知患有AF的印度裔亚洲患者的临床特征和治疗情况,我们研究了伯明翰西部六个全科诊所的患者。这六个全科诊所的联合执业人口为25051人,其中印度裔亚洲人口为14670人。共识别出12名已知患有AF的印度裔亚洲患者(6名男性,6名女性;平均年龄67岁;范围42至95岁),表明年龄>50岁的印度裔亚洲人中AF的患病率为0.6%。6名患者患有慢性AF,2名患者为近期发病(定义为发病<6个月),4名患者为阵发性AF。5名患者有缺血性心脏病史,3名患者有高血压,7名患者有心力衰竭,2名患者有酒精过量,4名患者有二尖瓣疾病,1名阵发性AF患者有病态窦房结综合征。无一例可归类为孤立性AF。只有4名患者接受了抗凝治疗,但其余8名未服用华法林的患者中,有6名正在服用阿司匹林。所有患者均无华法林使用禁忌证,但1名正在服用阿司匹林的患者对华法林依从性差。在这次对约14670名印度裔亚洲全科诊所人群的调查中,我们发现了12名已知患有AF的患者。鉴于这种常见心律失常对公共卫生的影响,仍迫切需要更多关于非白种人群中AF临床流行病学的信息。