CLINICAL PORTRAIT OF PATIENTS WITH ATRIAL FIBRILLATION: DATA OF OWN OBSERVATIONS IN A COHORT OF PATIENTS WITH COMORBID ARTERIAL HYPERTENSION AND DIABETES MELLITUS
DOI:
https://doi.org/10.11603/1811-2471.2021.v.i2.12054Keywords:
atrial fibrillation, arterial hypertension, diabetes mellitusAbstract
Atrial fibrillation (AF) is the most common arrhythmia that affects approximately 1–2 % population. It is assumed that by 2060 the number of people with AF will reach 17.9 million. A Framingham epidemiological study has shown that hypertension and diabetes mellitus are independent predictors of AF. Therefore, prevention and prediction of the course of this arrhythmia, especially in case of comorbidity, becomes even more relevant.
The aim – to conduct clinical and functional comparisons of the development and course of AF in comorbid hypertension and diabetes.
Material and Methods. 186 patients aged 20–74 years were examined. Among them, men – 55.9 %, women – 44.1 %. AF was detected in 80.1 % of patients (main group), no arrhythmias were detected in 13.4 % (control group).
Results. Examination of patients with AF revealed the following distribution by sex: men – 61,7 %, women – 38,3 %. Moreover, men were on average 4 years younger.
It was found that such a complication of hypertensive heart as AF most often occurs 10 years after the detection of hypertension. Moreover, with the development of diabetes AF occurs faster compared to isolated hypertension. The longer the history of hypertension and diabetes, the more patients had AF.
Clinically, patients with hypertension and diabetes often did not experience a recurrence of arrhythmia paroxysms, which probably influenced the progression of the pathology.
It turned out that long-term alcohol consumption has a direct impact on changes in echocardiography and, as a consequence, the occurrence of paroxysms of AF. The combination of hypertension and diabetes mellitus also has a significant effect on cardiac remodeling and AF persistence. And severe left ventricular hypertension in the group of patients with sinus rhythm and hypertension is probably associated with worse drug control of hypertension.
Conclusion. Therefore, AF in patients with hypertension and type 2 diabetes is characterized by less pronounced clinical symptoms, latent onset, progression of heart remodeling, a tendency to transform into a permanent form and a worse prognosis.
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