原发性高血压发生心房颤动的危险因素

目的探讨原发性高血压发生心房颤动的危险因素。方法306例符合纳入标准的单纯性原发性高血压病人整群随访5年,由专科医师进行降压治疗的同时记录随访结果。终检标准:心房颤动。影响心房颤动事件的因素用Cox风险比例模型鉴定。结果5年中,发生心房颤动86例(28.1%),平均年发生率5.6%,Cox回归分析显示年龄(HR=1.095,p=0.024)、左室重量指数(HR=1.137,p=0.000)、左房内径(HR=1.232,p=0.000)是原发性高血压发生心房颤动的独立预报因子。结论年龄、左室重量指数、左房内径是原发性高血压发生心房颤动的危险因素。

Effects of Factors on Atrial Fibrillation in Hypertension

Objective This study was undertaken to determine risk factor or factors for atrial fibrillation in hypertension.Methods 306 initially untreated subjects with essential hypertension were followed up for up to 5 years.At admission,all subjects were in sinus rhythm.Subjects with valvular heart disease,coronary artery disease,pre-excitation syndrome,thyroid disorders,or lung diseases were excluded.All subjects were treated with antihypertensive drugs.Atrial fibrillation was selected as prime end points.Risk factors were determined with multivariate analysis,and event-free survival curves were estimated.Results During 5-year follow-up,atrial fibrillation as primary end points occurred in 86 patients(5.6% per year).Age( risk ratio,HR 1.059,95% confidence interval of HR,95% CI 1.012-1.184),left ventricular mass index(HR 1.137,95% CI 1.068-1.211) and left atrial diameter(HR 1.232,95% CI 1.112-1.354) emerged as predictors of atrial fibrillation by multivariate analysis with Cox's proportional hazard model.Conclusion It is suggested that elderly patients with hypertension and those hypertensive patients with left ventricular hypertropy,or with left aerial dilatation are at risk for atrial fibrillation.