Prevalence and Risk Factors of Atrial Fibrillation in Chinese Elderly: Results from the Chinese Longitudinal Healthy Longevity Survey.
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2015-09
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Abstract
Background
Prevalence of atrial fibrillation (AF) is increasing as the world ages. AF is associated with higher risk of mortality and disease, including stroke, hypertension, heart failure, and dementia. Prevalence of AF differs with each population studied, and research on non-Western populations and the oldest old is scarce.Methods
We used data from the 2012 wave of the Chinese Longitudinal Healthy Longevity Survey, a community-based study in eight longevity areas in China, to estimate AF prevalence in an elderly Chinese population (n = 1418, mean age = 85.6 years) and to identify risk factors. We determined the presence of AF in our participants using single-lead electrocardiograms. The weighted prevalence of AF was estimated in subjects stratified according to age groups (65-74, 75-84, 85-94, 95 years and above) and gender. We used logistic regressions to determine the potential risk factors of AF.Results
The overall prevalence of AF was 3.5%; 2.4% of men and 4.5% of women had AF (P < 0.05). AF was associated with weight extremes of being underweight or overweight/obese. Finally, advanced age (85-94 years), history of stroke or heart disease, low high-density lipoprotein levels, low triglyceride levels, and lack of regular physical activity were associated with AF.Conclusions
In urban elderly, AF prevalence increased with age (P < 0.05), and in rural elderly, women had higher AF prevalence (P < 0.05). Further exploration of population-specific risk factors is needed to address the AF epidemic.Type
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Chei, Choy-Lye, Prassanna Raman, Chi Keong Ching, Zhao-Xue Yin, Xiao-Ming Shi, Yi Zeng and David B Matchar (2015). Prevalence and Risk Factors of Atrial Fibrillation in Chinese Elderly: Results from the Chinese Longitudinal Healthy Longevity Survey. Chinese medical journal, 128(18). pp. 2426–2432. 10.4103/0366-6999.164918 Retrieved from https://hdl.handle.net/10161/22826.
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Scholars@Duke
Yi Zeng
(1) Socioeconomic, behavior, environmental and genetic determinants of healthy aging and healthy longevity;
(2) Factors related to elderly disability and mental health;
(3) Methods of family households and elderly living arrangements forecasting/analysis and their applications in health services and socioeconomic planning, and market studies;
(4) Policy analysis in population aging, social welfare, retirement, and fertility transitions.
David Bruce Matchar
My research relates to clinical practice improvement - from the development of clinical policies to their implementation in real world clinical settings. Most recently my major content focus has been cerebrovascular disease. Other major clinical areas in which I work include the range of disabling neurological conditions, cardiovascular disease, and cancer prevention.
Notable features of my work are: (1) reliance on analytic strategies such as meta-analysis, simulation, decision analysis and cost-effectiveness analysis; (2) a balancing of methodological rigor the needs of medical professionals; and (3) dependence on interdisciplinary groups of experts.
This approach is best illustrated by the Stroke Prevention Patient Outcome Research Team (PORT), for which I served as principal investigator. Funded by the AHCPR, the PORT involved 35 investigators at 13 institutions. The Stroke PORT has been highly productive and has led to a stroke prevention project funded as a public/private partnership by the AHCPR and DuPont Pharma, the Managing Anticoagulation Services Trial (MAST). MAST is a practice improvement trial in 6 managed care organizations, focussing on optimizing anticoagulation for individuals with atrial fibrillation.
I serve as consultant in the general area of analytic strategies for clinical policy development, as well as for specific projects related to stroke (e.g., acute stroke treatment, management of atrial fibrillation, and use of carotid endarterectomy.) I have worked with AHCPR (now AHRQ), ACP, AHA, AAN, Robert Wood Johnson Foundation, NSA, WHO, and several pharmaceutical companies.
Key Words: clinical policy, disease management, stroke, decision analysis, clinical guidelines
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