心房颤动患者的危险因素分析

目的 探讨心房颤动(房颤)患者的相关危险因素,旨在防止房颤的发生. 方法 对我院2006年5月至2008年12月,643例房颤患者的住院资料进行回顾性分析,并按年龄分组,分析老年人房颤的特点. 结果 643例房颤患者,年龄40～94岁,男女比例为1∶0.68;房颤病因中,＜50岁患者最常见的是孤立性房颤,≥60岁患者的常见病因为高血压.非瓣膜性房颤患者中,阵发性房颤患者左心房直径显著小于持续性房颤和永久性房颤患者(P＜0.01),左心室射血分数显著高于持续性房颤和永久性房颤患者(P＜0.01).阵发性房颤患者中心功能Ⅱ～Ⅳ级所占比例较持续性房颤和永久性房颤患者明显减少(P＜0.01). 结论 房颤的发生随年龄增加而明显增加;高血压、冠心病、糖尿病、风湿性心脏病、心功能不全、心衰等均是房颤的危险因素.     

长期应用地高辛加小剂量胺碘酮治疗心衰并房颤

近年来,我们应用地高辛加小剂量胺碘酮治疗心衰并房颤23例,效果满意。现报告如下。 临床资料:本组60例,均为心衰并房颤住院患者。男39例,女21例,平均年龄(59.7±10.3)岁,风湿性心脏病8例,扩张型心肌病21例,冠心病31例,高血压心脏病10例,心功能Ⅱ级4例、心功能Ⅲ级21例,心功能Ⅳ级34例,60例随机分为对照组(37例)与治疗组(23例)。治疗组均在心衰恶化时住院应用西地兰、利尿剂、鲁南欣康、卡托普利及心肌营养药,     

心房颤动住院患者1650例临床分析

目的分析心房颤动住院患者病因、临床特点和抗凝治疗现状.方法对广东省心血管病研究所1998～2001年共1650例心房颤动住院患者的临床资料进行回顾性分析.结果心房颤动患者中阵发性、持续性和持久性房颤各占13.94%、6.42%、79.64%,风湿性心脏病是最常见的病因(67.88%),其次是高血压及冠心病(13.88%、7.52%).持久性房颤患者中68.42%心功能Ⅲ～Ⅳ级,与阵发性房颤相比有较大的左房内径[(51.94±12.46)mm∶(34.96±7.64)mm, P<0.01]和较低的左室射血分数[(69.40±12.98)%∶(74.93±12.08)%, P<0.001].房颤患者血栓栓塞事件发生率为25.45%,其中风湿性房颤为非风湿性房颤的5.21倍;非风湿性房颤患者华法令应用率为24.53%,而32.83%的患者出院时未接受任何抗凝治疗.结论研究提供了有价值的房颤流行病学资料;血栓栓塞是房颤的重要并发症,应得到临床医生充分的认识和足够的重视.     

老年充血性心力衰竭住院患者病因状况调查

目的了解充血性心力衰竭患者随年龄增长其病因构成的变化及多重病因情况.方法704例确诊为心衰的住院患者按年龄分为老年前期(45～59岁)组,老年(60～79岁)组和高龄老年(80～95岁)组,通过计算机Foxpro软件建立的老年CHF住院患者临床资料数据库,对比分析各组的病因构成及多病因情况.结果前三位的基础病因在老年前期组是风湿性心脏病(47.1%)、冠心病(19.9%)和扩张性心肌病(12.7%),老年组是冠心病(62.2%)、高血压(14.6%)和风湿性心脏病(11.9%),高龄老年组是冠心病(92.0%)、高血压(30.0%)和贫血(22.0%);多病因心衰在老年前期组占25.7%,老年组占70.7%,高龄老年组82.0%;多病因组合中,双病因最多见的是冠心病、高血压,三种及以上病因中最多见的组合是冠心病、高血压和糖尿病.结论心衰患者随年龄老化,(1)风心病和心肌病的比率逐渐下降,而冠心病、高血压和贫血的比例逐渐增大;(2)多病因心衰比例逐渐增大;(3)冠心病、高血压和糖尿病成为最常见的多病因组合.上述特点在老年心衰的诊治和预防中应当引起注意.     

非瓣膜病性心房颤动合并脑血管血栓栓塞(缺血性脑卒中)的临床与防治

心律失常是临床常见的一种表现 ,心电图检查除各种性质期前收缩 (早搏 )外 ,心房颤动 (房颤ＡＦ)也是常见的一种。房颤多发生于器质性心脏病患者 ,约占总数的 85 %～ 90 % ,如高血压、冠心病 (心绞痛、急性心肌梗死 )、心肌病、风湿性心瓣膜病 (如二尖瓣狭窄等 )。无器质性心脏病者 10 %～ 15 %也可有房颤 ,临床上统称为孤立性房颤。房颤病人常伴有的心脏病85 %～ 90 %的房颤伴有器质性心脏病5 0 %有高血压2 5 %有冠心病10 %～ 15 %不伴有器质性心脏病 ,称孤立性房颤近 2 0余年来由于风湿性心瓣膜病患者较 2 0世纪 6 0年代明显减少 ,相反 ,…     

心房颤动急诊患者的现状调查

目的:探讨心房颤动(房颤)急诊患者的病因、临床特点及治疗现状.方法:对我院2006-01至2006-12在急诊就诊的房颤患者按时间均衡抽样后,随机选择944例患者对其年龄、房颤史、原发疾病、超声心动图及抗心律失常、抗凝等用药情况进行回顾性分析.结果:入选944例房颤患者中,年龄为15～97岁,男女比例1:0.88;房颤病因中,<45岁年龄段、45～64岁年龄段的最常见病因为风湿性心脏病,≥65岁年龄段患者的常见病因为高血压,全都944例患者最常见病因为风湿性心脏病.944例患者中孤立性房颤为200例(21.2%).非瓣膜性房颤患者中,阵发性房颤患者左心房直径均显著小于持续性房颤和永久性房颤患者(P均<0.001),左心室射血分数显著高于持续性房颤和永久性房颤患者(P均<0.001),差异均有统计学意义.阵发性房颤患者心功能Ⅱ-Ⅳ级所占比例较持续性房颤和永久性房颤患者均明显减少(P均<0.001),差异均有统计学意义.全部房颤患者的药物治疗方面,使用B阻滞剂404例(42.7%),地高辛389例(41.2%),非二氢吡啶钙拮抗剂163例(17.3%),胺碘酮59例(6.3%),IC类药物54例(5.7%).全部患者中合并血栓栓塞者79例(8.4%),其中使用华法林抗凝者有23例(29.1%).瓣膜性房颤患者中用华法林抗凝有160例(48.2%);非瓣膜性房颤患者中用华法林抗凝有43例(7.1%).结论:急诊房颤患者的病因、临床特点与国内一般人群的情况基本相似,药物治疗中以控制心室率为主;血栓栓塞是房颤重要的并发症,抗凝治疗需要进一步加强.     

老年慢性充血性心力衰竭患者血清肌钙蛋白T的观察

一、对象和方法　　 1.对象 :1997年 4月至 1998年 4月选择我院心内科老年慢性充血性心力衰竭 (心衰 )住院患者 (心衰组 ) 6 2例 ,男2 8例 ,女 34例 ,年龄 6 0～ 81岁 ,平均 (6 8± 11)岁。按照纽约心脏病协会 (ＮＹＨＡ)心功能分级标准 ,心功能均在Ⅱ～Ⅳ级。其中冠心病 42例 ,高血压性心脏病 5例 ,风湿性心脏病 9例 ,扩张性心肌病 3例 ,老年退行性心瓣膜病 3例。冠心病患者均符合 1979年ＷＨＯ的诊断标准 ,除外近期急性心肌梗死及不稳定心绞痛者。按下列方法分组 :(1)按ＮＹＨＡ心功能分级标准将患者分为Ａ组 (心功能Ⅱ、Ⅲ级 )30例和Ｂ组…     

心力衰竭患者心功能状态与血钾水平关系

心力衰竭(心衰)是各种心脏疾病的终末阶段,而低血钾作为重要的离子代谢紊乱又可诱发和加重心衰。本文通过对452例心脏病患者有关资料进行回顾性分析,探讨低血钾发生与心功能以及不同心脏病之间的关系。报告如下。1　临床资料452例均为我院3年内住院确诊的心脏病患者,其中心功能代偿者108例,心衰344例,级50例,级178例,级116例;高血压心脏病135例(心衰102例),冠心病125例(心衰90例),肺源性心脏病142例(心衰108例),风湿性心脏病42例(心衰40例),甲亢心脏病、心肌病、先天性心脏病共8例(心衰4例);男310例,女142例;年龄22～85(平均63.7)岁。符合以…     

心力衰竭患者自主神经功能与临床相关因素的研究

本研究通过对不同病因的慢性心力衰竭 (心衰 )患者的心率变异性 (HRV)分析 ,探讨慢性心衰患者自主神经功能活动与心功能受损的严重程度及其临床诸因素的相关性。1.资料与方法 :1999年 1月～ 2 0 0 1年 6月门诊或住院患者共 97例 ,分为两组 :(1)对照组 35例 ,男2 3例 ,女 12例 ,年龄 2 6～ 75 (5 5± 11)岁 ,无器质性心脏病。 (2 )慢性心衰组 6 2例 ,男 4 2例 ,女 2 0例 ,年龄 2 8～ 82 (5 7± 13)岁 ,其中高血压病 16例、冠心病13例、高血压合并冠心病 13例、病毒性心肌炎 7例、肺原性心脏病 6例、扩张性心肌病 5例、风湿性心脏病 2例。所…     

3008例哈萨克族心血管疾病住院患者调查分析

目的:分析哈萨克族心血管疾病住院患者病种的构成比、年龄分布及各种心血管疾病的平均增长速度,探讨哈萨克族心血管疾病情况及变化趋势.方法:回顾性分析1997-01-2006-12 3 008例按国内同期标准诊断的住院哈萨克族心血管疾病资料,按年度对心血管疾病病种和年龄进行分析. 结果:3 008例心血管疾病住院患者男性共1 997例,年龄(54 55±15 66)岁,女性1 011例,年龄(49 66±15 10)岁,两者差异有统计学意义(P<0 01).原发性高血压、冠心病、不明原因的心律失常、风湿性心脏病、先天性心脏病、肺源性心脏病、原发性心肌病、心脏神经症和其他心血管疾病的构成比分别是50 20%、18 82%、11 67%、5 68%、3 99%、3 58%、1 96%、1 33%和2 86%.原发性高血压、冠心病、心律失常、风湿性心脏病、先天性心脏病、肺源性心脏病、原发性心肌病平均增长速度分别是20 68%、18 98%、27 26%、3 10%、20 49%、9 59%、17 46%.所有心血管疾病的总体平均增长速度是18 99%.50~70岁年龄段分布占整个年龄段的58 04%,高血压、冠心病和心律失常的住院年龄段以60~70岁占首位.结论:应加强该地区哈萨克族心血管病,尤其是40岁以上居民原发性高血压、冠心病和心律失常的预防工作.     

1410例慢性心力衰竭合并心房颤动住院病例回顾性分析

目的分析慢性心力衰竭合并心房颤动住院病例的特点。方法采用2中心、回顾性、对照研究。对病例在年代(Ⅰ、Ⅱ、Ⅲ组)、性别、年龄分期等方面的特点进行分析。结果入选1 410例,年龄呈现老龄化(P<0.01)。心功能以NYHAⅢ、Ⅳ级为主,占87.9%。Ⅰ和Ⅱ组的首位病因是风湿性心脏病,Ⅲ组则是冠心病。随着年龄的增加,女性患者心房颤动比例减少。老年前期首位病因是风湿性心脏病,老年期和高龄老年期则为冠心病。总的好转率82.9%,总的病死率12.6%,后者以Ⅲ组最低(P<0.01)。死亡病例的首位病因逐渐由风湿性心脏病演变为冠心病,死因以非心脏性原因死亡居多,其次为心功能恶化。结论慢性心力衰竭合并心房颤动住院病例的首位病因从风湿性心脏病演变为冠心病;高龄、冠心病合并心房颤动可能逐渐成为慢性心力衰竭的主要流行趋势。     

Cardiovascular complications in newly diagnosed rheumatic heart disease patients at Mulago Hospital,Uganda

Background

Complications of rheumatic heart disease are associated with severe morbidity and mortality in developing countries where the disease prevalence remains high. Due to lack of screening services, many patients present late, with severe valve disease. In Uganda, the disease and its complications are still not well studied.

Objective

To profile and describe cardiovascular complications in newly diagnosed rheumatic heart disease patients attending the Mulago National Referral Hospital in Uganda.

Methods

This was a cross-sectional study where consecutive, newly diagnosed rheumatic heart disease patients were assessed and followed up for complications, such as heart failure, pulmonary hypertension, atrial fibrillation, recurrence of acute rheumatic fever, and stroke.

Results

A total of 309 (115 males and 196 females) definite rheumatic heart disease patients aged 15–60 years were enrolled in the study and analysed. Complications occurred in 49% (152/309) of the newly diagnosed rheumatic heart disease cases, with heart failure (46.9%) the most common complication, followed by pulmonary arterial hypertension (32.7%), atrial fibrillation (13.9%), recurrence of acute rheumatic fever (11.4%), infective endocarditis (4.5%) and stroke (1.3%). Atrial fibrillation and acute rheumatic fever were the most common complications associated with heart failure.

Conclusion

In this study we found that about 50% of newly diagnosed rheumatic heart disease patients in Uganda presented with complications. Heart failure and pulmonary arterial hypertension were the most commonly observed complications.     

A 13-year follow-up study of rheumatic valvular diseases

A 13-year follow-up study was performed in 301 patients with rheumatic heart disease (RHD). Of these patient, 223 cases, 78 men (average age 59.3 years) and 145 women (average age 60.4 years), survived. Seventy-eight cases including 38 men (mean age of death 72.5 years) and 40 women (mean age of death 64.8 years) died. RHD consisted of 51% mitral valvular diseases, 40% combined valvular diseases and 9% aortic valvular diseases. The mean mortality for all patients with RHD was 25.9%. Seventy percent of the deaths were due to severe, chronic heart failure, sudden death and cerebral emboli. Atrial fibrillation was observed in 50% of the patients. Cerebral emboli occurred frequently in patients with mitral stenosis (MS), mitral stenoregurgitation (MSR) and combined valvular disease (CVD), which were associated with atrial fibrillation. However, cerebral emboli were rarely found in cases with MSR, CVD and aortic valvular disease with sinus rhythm. The mortality of cardiac surgery was low, 13.3%.     

Treatment of atrial fibrillation in a district general hospital.

OBJECTIVE--To assess current strategies used to investigate and manage acute atrial fibrillation in hospital. DESIGN--Prospective survey of all acute admissions over 6 months. SETTING--District general hospital serving a population of 230,000 in north east Glasgow. SUBJECTS--2686 patients admitted as emergency cases over 6 months. RESULTS--Of the 2686 patients, 170 (age range 38-95, mean (SD) 73.5 (10.6) years; 70 men (41%) and 100 women (59%)) were admitted with atrial fibrillation. The principal underlying medical conditions were ischaemic heart disease in 79 (46.5%), rheumatic heart disease in 26 (15.3%), and thyroid disease in six (3.5%). Cardiac failure was present on admission in 61 (36%), cerebrovascular events in 23 (14%), and myocardial infarction in 17 (10%). Of those with a history of atrial fibrillation (102 (60%) including 10 with paroxysmal atrial fibrillation) treatment on admission included digoxin in 71 (70%), warfarin in 20 (20%), and aspirin in 17 (17%); the aspirin was predominantly given for concomitant vascular disease. The mean (SD) inpatient stay was 16 days (19.7) (range 1-154) largely due to the patients with stroke. Thyroid function tests were performed in only 63% and echocardiography in 33%. Overall, the rate of introduction of anticoagulation (seven patients) and attempted cardioversion (21 patient: 19 pharmacological and two electrical) was surprisingly low. Only 49 patients (34% of those not on warfarin) had contraindications to anticoagulation: these included peptic ulcer or gastrointestinal bleeding in 18 (12%), dementia in eight (6%), chronic renal failure or dialysis in eight (6%), and alcohol excess in four (3%). CONCLUSION--Standard investigations were inadequately used in patients with atrial fibrillation and there was a reluctance to perform cardioversion or to start anticoagulant treatment.     

Hospitalizations for atrial fibrillation in the general male population: morbidity and risk factors

OBJECTIVES: To analyse the incidence, prevalence, aetiology, risk factors and prognosis of hospitalizations for atrial fibrillation. SUBJECTS: A random population sample of 7495 men aged 47-55 years was first examined in 1970-73. During follow-up until 1996 (mean 25.2 years) 754 men were hospitalized with a diagnosis of atrial fibrillation. RESULTS: In the age groups of 55-64, 65-74 and 75-79 years, the incidence rate was 2.0, 5.8 and 17.3 per 1000 person years, and the prevalence 1.2, 4.2 and 8.0%, respectively. Definite or possible coronary heart disease was diagnosed in 46.0%, heart failure in further 20.2% and valvular heart disease or cardiomyopathy in 4.5%. In bivariate analysis adjusted for age, the following factors were significantly associated with future hospitalization for fibrillation: a family history of myocardial infarction, stroke in mother, dyspnoea at entry, alcohol abuse, high body stature and body weight, high blood pressure but not diabetes, high serum cholesterol, high heart rate, smoking, coffee consumption or psychological stress. Significant risk factors in multivariate analysis were age, odds ratio (OR) [95% confidence interval (CI)] -1.11 (1.07, 1.16) per year, hospitalization for coronary heart disease or heart failure -6.77 (5.17, 8.87), stroke in mother - 1.49 (1.15, 1.93), high body stature -1.04 (1.03, 1.06) per cm, high body mass index (BMI) -1.07 (1.04, 1.10) per kg m(-2), as well as hypertension -1.33 (1.07, 1.65). After a diagnosis of atrial fibrillation, mortality was increased by 3.3 times. CONCLUSION: In spite of a clinical association with coronary heart disease, risk factors for atrial fibrillation were only partly the same. Prevention includes avoidance of weight gain and control of blood pressure as well as prevention of myocardial infarction and heart failure.     

1335例心房颤动住院患者病因(或相关因素)分析

目的探讨心房颤动(房颤)住院患者的病因(或相关因素)。方法对我院2000年1月~2005年12月出院时诊断为房颤的1335例患者的临床资料进行回顾性分析。结果(1)入选患者1335例,年龄为19~101(68.7±11.9)岁,男女比例为1.31∶1,阵发性、持续性、永久性房颤分别为54.7%、10.6%、34.7%。(2)房颤病因(或相关因素)统计:老年70%,高血压57.3%,冠心病26.3%,风湿性心脏病12.8%,糖尿病19.8%,贫血18.6%。54.1%合并有心房扩大,12.6%有左心室射血分数下降。<45岁年龄组的首位病因(或相关因素)为风心病,而≥45岁年龄组为高血压。(3)随着高血压病程延长,房颤发生增加,但左心房内径无进一步增加。(4)房颤患者左心房前后径为阵发性房颤<持续性房颤<永久性房颤[(38.81±7.69)mm<(43.55±8.05)mm<(48.05±10.33)mm,P<0.05]。(5)随着房颤病程的延长左心房前后径增加[<5年:(39.98±8.05)mm,5~10年:(44.18±10.84)mm,>10年:(46.17±10.63)mm,P<0.05]。结论老年和高血压是房颤最常见的病因(或相关因素),应积极控制高血压,减少或延缓房颤的发生、发展。     

Hyperthyroidism and risk of atrial fibrillation or flutter: a population-based study

BACKGROUND: Atrial fibrillation is a common cardiac manifestation of hyperthyroidism. The relation between hyperthyroidism and atrial fibrillation has so far been analyzed in a limited number of selected patients, and the strength of the association has not been estimated. We examined the risk of atrial fibrillation among patients aged 20 to 89 years with hyperthyroidism diagnosed in hospitals in Denmark during a 20-year period. METHODS: We identified all patients with an incident hospital diagnosis of hyperthyroidism during the study period in the Danish National Registry of Patients, and among those we identified patients with a diagnosis of atrial fibrillation or flutter that occurred +/-30 days from the date of the hospital diagnosis of hyperthyroidism. We used logistic regression analysis to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between sex, 10-year age group, cardiovascular diseases, and risk of atrial fibrillation or flutter. RESULTS: Among 40 628 patients diagnosed as having hyperthyroidism, 3362 (8.3%) were diagnosed as having atrial fibrillation or flutter within +/-30 days from the date of the diagnosis of hyperthyroidism. The following factors were associated with risk of atrial fibrillation or flutter: male sex (OR, 1.8; 95% CI, 1.6-1.9), age (OR, 1.7; 95% CI, 1.7-1.8) per 10-year increment, ischemic heart disease (OR, 1.8; 95% CI, 1.6-2.0), congestive heart failure (OR, 3.9; 95% CI, 3.5-4.4), and heart valve disease (OR, 2.6; 95% CI, 1.9-3.4). CONCLUSION: Male sex, increasing age, ischemic heart disease, congestive heart failure, and heart valve disease are associated with an increased risk of atrial fibrillation or flutter in patients with hyperthyroidism.     

Retrospective investigation of hospitalised patients with atrial fibrillation in mainland China

OBJECTIVE: To evaluate the epidemiology and status of atrial fibrillation in China. METHODS: Retrospective analysis of hospital records of patients with a primary diagnosis of atrial fibrillation, discharged between January 1999 and December 2001. RESULTS: Data were analysed from 9297 patients (mean age 65.5 years) from 41 hospitals in mainland China. During the period studied, atrial fibrillation admissions (mean 7.9%) increased as a proportion of cardiovascular admissions. The distribution of atrial fibrillation increased with age. Causes and associated conditions were advanced age (58.1%), hypertension (40.3%), coronary heart disease (34.8%), heart failure (33.1%), rheumatic valvular disease (23.9%), idiopathic atrial fibrillation (7.4%), cardiomyopathy (5.4%) and diabetes (4.1%). Permanent atrial fibrillation accounted for almost half of the patients (49.5%), and paroxysmal and persistent atrial fibrillation the remainder (33.7% and 16.7%, respectively). Paroxysmal atrial fibrillation was treated mainly by rhythm control (56.4%). In 82.8% of patients with chronic atrial fibrillation, a rate-control strategy was used. The prevalence of stroke was 17.5%. In non-valvular atrial fibrillation, risk factors associated with stroke included advanced age, history of hypertension, coronary heart disease and type of atrial fibrillation. A total of 64.5% of patients received antithrombotic therapy, predominantly with antiplatelet agents. Patients managed with antiplatelet or anticoagulant drugs had a significantly lower stroke rate than those receiving neither treatment, but there was no significant difference between antiplatelet and anticoagulant agents. CONCLUSION: Most of the atrial fibrillation-related epidemiological factors in this population were similar to those reported in other countries. Antiplatelet and anticoagulant treatment both reduced stroke rate significantly.     

Influence of age on prevalence rates of chronic complications of hospitalized aged patients with hypertension——analysis of 17,682 cases

Objective To understand the relationship between age and chronic complications in hospitalized aged patients with hypertension, to provide evidence for hypertension prevention and control. Methods To retrospectively analyze the clinical and laboratory data on 17,682 patients with essential hypertension during Jan 1 s,, 1993-Dec 12th, 2008 in PLA general hospital. Results 1） Among all of the inrolled cases, those aged 60-64 account for 27.87%, 65-69 years group account for 26.55%, 70-74 years group accounted for 23.96%, 75-79 years group accounted for 14.14%, 80-84 years group accounted for 5.26%, 85-89 years group accounted for 1.69%, 〉 90 years accounted for 0.41%. 2） The prevalence rate of chronic complications in 60-69 years group were 31.3-31.2% for diabetes and,22.6-27.0% for cerebrovascular disease, 9.5-11.1% for myocardial infarction, 6.7-9.1% for heart failure, 5.8-6.0% for renal dysfanction 4.9-6.8% for atrial fibrillation, 0.1-0.3% for multiple organ dysfunction syndrome （MODS） in the elderly（P 〈0.05 ）. 3） The first four complications of hypertension were diabetes（33.5%）, cerebrovascular disease （31.9%）, myocardial infarction（13.2%） and heart failure（12.3%） in 70-74 years group （P〈0.05）, cerebrovascular disease （42.8%）, diabetes （32.8%）, heart failure （16.5%） and myocardial infarction（15.9%） in 75-79 years group （P〈0.05）, cerebrovascular disease （45.4%）, diabetes （35.0%）, heart failure （21.1%） and myocardial infarction（l 5.9%） in 80-84 years group （P〈0.05）, cerebrovascular disease（42.5%）, diabetes （35.8%）, heart failure （23.1%） and renal dysfanction （17.7%） in 85-89 years group（P〈0.05 ）,and cerebrovascular disease （45. 2%）, heart failure（31.5%） , diabetes （26.0%） and renal dysfanction （20.5%） in patients more than 90 years group （P〈0.05）. Conclusions The prevalence rate and kinds of chronic complications in hospitalized aged patients with hypertension were changed with the increasing age, and the first kind of complication is cerebrovascular disease. It is of more importance to prevent the occurrence of renal dysfanction and heart failure in those hypertension patients who were more than 80 years old.     

Risk factors for stroke in chronic atrial fibrillation

Atrial fibrillation is associated with an increased risk ofstroke. Different risk factors may be of importance regardingstroke incidence and mortality in atrial fibrillation. Retrospectively,we studied 786 patients with chronic atrial fibrillation, 229with rheumatic heart disease and 557 without. In all, 127 patientshad stroke (16%). Using Cox's proportional hazard model forfailure-time data with age, gender, etiology, degree of heartfailure and cardiac enlargement as explanatory (independent)variables, only etiology (rheumatic heart disease) was a significantrisk factor for stroke (P<0.006). Significant risk factorsfor death in 653 patients without stroke were age (P= 0.000)and congestive heart failure at the onset of atrial fibrillation(P = 0.000). The need to identify other risk factors for strokein patients with atrial fibrillation is emphasized, for selectingpatients at high risk for prophylactic treatment with anticoagulantsor aspirin.