Prevalence of atrial fibrillation in different socioeconomic regions of China and its association with stroke: Results from a national stroke screening survey

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice. This study aimed to estimate the prevalence of AF in different socioeconomic regions of China and identify its association with stroke, through a national survey.

Methods: The study included 726,451 adults aged ≥40 years who were participants of the China National Stroke Screening and Prevention Project, a nationally representative cross-sectional study. Stepwise logistic regression analyses were conducted to investigate the association between AF and stroke.

Results: The overall standardized prevalence rate of AF was 2.31%. The prevalence of AF was highest in high-income regions (2.54%), followed by middle-income regions (2.33%), and lowest in low-income regions (1.98%). Women had a higher prevalence of AF than men in all regions (low-income regions, 2.30% vs 1.65%; middle-income regions, 2.78% vs 1.89%; and high-income regions, 2.96% vs 2.12%). Compared with urban residents, the prevalence of AF among rural residents was higher in low- (2.03% vs 1.91%) and middle-income regions (2.69% vs 1.90%), but lower in high-income regions (2.44% vs 2.58%). Participants with AF were more likely to have a stroke than those without AF (9.48% vs 2.26%). After adjusting for age, sex, location, overweight or obese, smoking, drinking, physical inactivity, hypertension, diabetes, dyslipidemia, and a family history of stroke, results showed that AF was significantly associated with stroke.

Conclusions: The prevalence of AF has increased in recent years, and it was positively correlated with socioeconomic status, sex (women), location (rural areas), and stroke.