The latest results of the endocrinology team of the Ninth Hospital: High blood pressure and overweight and obesity are key factors in preventing atrial fibrillation risk
The Lu Yingli/Wang Ningjian team from the Department of Endocrinology of the Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine recently published research results in the internationally renowned journal "European Heart Journal", revealing that the control of metabolic factors plays a prominent and important role in the primary prevention system of atrial fibrillation.
Atrial fibrillation is a common cardiac arrhythmia. Its onset significantly increases the risk of complications such as death, stroke, and heart failure. The risk factors for atrial fibrillation are complex and diverse. In addition to metabolic factors such as overweight and obesity, hyperglycemia, and hypertension, society Factors, lifestyle, and comorbidities are all associated with the development of atrial fibrillation. However, research on the independent impact of various risk factors on atrial fibrillation at different ages and genetic backgrounds is still lacking.
To this end, the Lu Yingli/Wang Ningjian team based on the atrial fibrillation guidelines released by the European Society of Cardiology in 2020, finally selected 37 risk factors and analyzed the new incidence of 23 risk factors in each age group and each genetic risk group. Atrial fibrillation hazard ratios and population-attributable risks. This prospective cohort study has a long time span, involves a wide range of people, has a follow-up period of up to 12 years, and includes about 410,000 people.
The study found that most metabolic factors and clinical comorbidities had significant interactions with age, that is, risk factors were more strongly associated with atrial fibrillation in younger people. Across all age groups and genetic risk groups, metabolic factors consistently accounted for the highest proportion of new-onset AF cases, followed in order by clinical comorbidities, health behaviors, and social factors. Among them, hypertension and overweight and obesity are the two modifiable factors with the largest population-attributable risk. As genetic risk decreases, population-attributable risk due to metabolic factors and clinical comorbidities gradually increases.
It was concluded that controlling metabolic factors, especially hypertension and overweight and obesity, is a key part of atrial fibrillation prevention strategies across age and genetic risk groups. By controlling metabolic factors, greater results can be achieved in people with low genetic risk, and more new-onset atrial fibrillation can be prevented in people with high genetic risk.
So far, this study will effectively promote multidisciplinary cooperation in the prevention and treatment of atrial fibrillation in the discipline of endocrinology and metabolism through a more comprehensive analysis of atrial fibrillation risk factors, and provide evidence for the body's steady-state metabolism to promote precise and effective prevention and control of atrial fibrillation. It effectively improves relevant risk assessment and provides professional research support for government and industry decision-making.
Professor Lu Yingli from the Department of Endocrinology of the Ninth Hospital is the final corresponding author of the paper, and Wang Ningjian, deputy chief physician/researcher, is the first author and corresponding author. This study was funded by the Shanghai Municipal Human Resources and Social Security Bureau, Shanghai Municipal Health Commission, and Shanghai Shenkang Major Clinical Research Project.
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