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Atrial fibrillation more common in adults with diabetes, hypertension
Chinese adults with diabetes and hypertension are more likely to have atrial fibrillation when compared with normotensive adults with diabetes, according to research in the Journal of Diabetes Investigation.
In a cross-sectional study, Guozhe Sun, MD, of the First Hospital of China Medical University in Shenyang, China, and colleagues analyzed data from 11,341 residents of Liaoning province, China, aged at least 35 years and selected through a multistage, randomly stratified and cluster-sampling format (6,169 women; mean age, 54 years; 1,171 with diabetes). Between January and August 2013, participants completed a questionnaire and in-person interview, and they underwent a physical examination, fasting blood sample, electrocardiogram and echocardiogram to diagnose atrial fibrillation. Researchers used logistic regression analyses to estimate associations between diabetes and atrial fibrillation, including separate analyses in subgroups of hypertensive and normotensive participants.
Within the cohort, 1.2% of adults with diabetes had atrial fibrillation vs. 0.5% of adults without diabetes (P = .004). Adults with diabetes and hypertension had a higher rate of atrial fibrillation vs. hypertensive adults without diabetes (1.5% vs. 0.6%; P = .008), whereas rates were similar among normotensive adults with and without diabetes. There were no significant between-sex differences, according to researchers.
Researchers found an independent association between diabetes and atrial fibrillation for the entire cohort after adjusting for age, sex, BMI, cardiovascular disease risk factors, and smoking and drinking status (OR = 2.33; 95% CI, 1.2-4.54), as well as in the hypertensive group (OR = 3.15; 95% CI, 1.52-6.56). There was no association found in the normotensive group after multivariable adjustment.
“Impaired glucose metabolism may be the underlying mechanism causing the different results between the two [blood pressure] groups,” the researchers wrote. “Insulin resistance, which plays a key role in [diabetes], has been a powerful independent predictor of [left ventricular hypertrophy]. ... So, insulin resistance and its corresponding [left ventricular hypertrophy] may be the mechanisms mediating the [diabetes]-related [atrial fibrillation] prevalence.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.