Association Between Non-valvular Atrial Fibrillation And Renal Function In Patients With Hypertension

Objective: By analyzing the creatinine,uric acid,urea and estimated glomerular filtration rate in patients with hypertension,this study aims to explore the correlation between the occurrence of non-valvular atrial fibrillation and renal function in patients with hypertension,so as to provide theoretical basis for the treatment and prevention of non-valvular atrial fibrillation.Methods: From June 2018 to October 2019,a total of 354 hypertensive patients who met the criteria of admission and discharge in the cardiovascular department of the second hospital of Lanzhou University were selected as the study objects.According to whether they had non-valvular atrial fibrillation,they were divided into two groups: hypertension with non-valvular atrial fibrillation group(n = 177)and hypertension without non-valvular atrial fibrillation group(n = 177).At the same time,the subjects over 45 years old were divided into middle age group and old age group according to their age.The general data,clinical test results,related data of echocardiography and electrocardiographic indexes of all subjects were collected by Excel.SPSS 22.0 statistical software package was used to analyze and calculate the data to determine whether there is correlation between NVAF and renal function in patients with hypertension.Results: 354 patients with hypertension were included in this study,including177 patients in hypertension with non-valvular atrial fibrillation group,177 patients in hypertension without non-valvular atrial fibrillation group,39 patients in grade 1,72 patients in grade 2,243 patients in grade 3,and stroke patients in both groups 58 cases.There was no significant difference in age,gender,body mass index,stroke,hypertension grade,high-density lipoprotein cholesterol and so on between atrial fibrillation group and non-atrial fibrillation group(P > 0.05).There were significant differences in low-density lipoprotein cholesterol,Total cholesterol,triglyceride,estimated glomerular filtration rate,creatinine,uric acid,urea,left ventricular ejection fraction,left ventricular end systolic diameter,left ventricular end diastolic diameter and left atrial diameter between the two groups(P < 0.05).Multivariate logistic regression analysis was carried out between hypertension with non-valvular atrial fibrillation and hypertension without non-valvular atrial fibrillation.The results showed that: left atrial diameter [OR = 1.167,95% CI,(1.107,1.231),P < 0.05],left ventricular ejection fraction [OR = 0.916,95% CI,(0.862,0.975),P < 0.05],estimated glomerular filtration rate [OR = 0.963,95% CI,(0.940,0.986),P < 0.05]were the independent risk factor of non valvular atrial fibrillation in patients with hypertension(P < 0.05),while triglyceride,low density lipoprotein,total cholesterol,uric acid,urea,creatinine,left ventricular end systolic diameter and left ventricular end diastolic diameter were not the independent risk factors of non-valvular atrial fibrillation in patients with hypertension(P > 0.05).The subjects over 45 years old were divided into the middle-aged group and the old-age group according to the who age standard.Statistical analysis was carried out on the two age groups: in the middle-aged group,there were statistical differences between the AF group and the non AF group in the estimation of glomerular filtration rate,creatinine,urea,left ventricular ejection fraction,left ventricular end systolic diameter,left ventricular end diastolic diameter and left atrial diameter(P < 0.05)There was no significant difference in age,gender,BMI,hypertension classification,stroke,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,triglyceride,total cholesterol,uric acid,etc.(P > 0.05);in the old-age group,there was a significant difference in total cholesterol,triglyceride,low-density lipoprotein cholesterol,creatinine,estimated glomerular filtration rate,left atrial diameter,left atrial diameter between the two groups.There was no significant difference between the two groups in gender,age,body mass index,hypertension grade,stroke,high-density lipoprotein cholesterol,urea,uric acid and left ventricular end diastolic diameter(P > 0.05).Logistic regression analysis was carried out for two age groups: left atrial diameter and estimated glomerular filtration rate were independent risk factors for the occurrence of non-valvular atrial fibrillation in middle-aged hypertensive patients(P <0.05);left atrial diameter,left ventricular end systolic diameter,left ventricular ejection fraction and estimated glomerular filtration rate were independent risk factors for the occurrence of non-valvular atrial fibrillation in elderly hypertensive patients(P<0.05)?Conclusion: 1.It is that the reduction of estimated glomerular filtration rate is an independent risk factor for NVAF in patients with hypertension.There is a correlation between NVAF and renal function in patients with hypertension.2.Increased left atrial diameter and decreased left ventricular ejection fraction are independent risk factors for NVAF in patients with hypertension.3.There is a positive correlation between the increase of left ventricular end systolic diameter and NVAF in elderly patients with hypertension.