Influencing Factors Analysis Of Primary Hypertension Complicated With Paroxysmal Atrial Fibrillation

BackgroundThe incidence of atrial fibrillation has increased significantly along with demographic changes and the increasing incidence of cardiovascular disease.At present,hypertension is the most important risk factor and cause of atrial fibrillation worldwide.Atrial fibrillation is a process of gradual occurrence and development.In hypertension groups,paroxysmal atrial fibrillation is most likely to occur first,which will develop into persistent atrial fibrillation without intervention,and then the process of permanent atrial fibrillation.Therefore,it is of great significance to focus on the identification of paroxysmal atrial fibrillation.At present,most studies have not elaborated on the influencing factors of paroxysmal atrial fibrillation complicated with primary hypertension.ObjectiveThrough the study of primary hypertension complicated with paroxysmal atrial fibrillation,to explore the predictive value of related influencing factors on the occurrence of paroxysmal atrial fibrillation in hypertension groups.It is helpful to identify the occurrence of paroxytic atrial fibrillation in patients with hypertension as early as possible,and then prevent and cure the occurrence and development of atrial fibrillation and the subsequent risk and social burden of the corresponding cardiovascular and cerebrovascular diseases.MethodsAcquisition between September 2018 and October 2020 to the first affiliated hospital of Xinxiang medical college,hospitalized patients with cardiovascular internal medicine screening of patients with primary hypertension,according to the presence of a diagnosis of paroxysmal atrial fibrillation were divided into high blood pressure,high blood pressure,paroxysmal atrial fibrillation group,to invite the baseline data,inspection index,heart colour to exceed index were analyzed.The rate and percentage of enumeration data were expressed,and the statistical method wasχ~2 test.The measurement data met the normal test and was represented byχ±s.The statistical method was independent sample t test.If it does not meet the normality test,it is represented by the median and quartile spacing,and the statistical method is non-parametric test.The factors influencing hypertension complicated with paroxysmal atrial fibrillation were analyzed by binary Logistic regression analysis,and the ROC curve for predicting hypertension complicated with atrial fibrillation was established,and P<0.05 was considered statistically significant.ResultsHigh blood pressure and hypertension paroxysmal atrial fibrillation group in age,systolic pressure,diastolic blood pressure,creatinine,uric acid,total cholesterol,high density lipoprotein cholesterol,low density lipoprotein cholesterol,left atrial diameter,left ventricular posterior wall thickness and interventricular septum thickness,left ventricular end-diastolic diameter,left ventricular end systolic diameter and left ventricular ejection fraction 14 indicators on the difference had statistical significance(P<0.05).Among them,elevated age(OR=1.103,95%CI:1.069-1.137),uric acid(OR=1.004,95%CI:1.001-1.008),left atrial diameter(OR=1.221,95%CI:1.144-1.303),and interventricular septal thickness(OR=1.551,95%CI:1.209-1.990)were adverse factor for hypertension complicated with paroxysmal atrial fibrillation.Elevated left ventricular end systolic diameter(OR=0.893,95%CI:0.801-0.995),left ventricular ejection fraction(OR=0.843,95%CI:0.8780-0.910),and low density lipoprotein(OR=0.580,95%CI:0.369-0.912)were favorable influencing factors of hypertension complicated with paroxysmal atrial fibrillation.In the ROC curve for predicting hypertension with paroxytic atrial fibrillation,the area under the curve of left atrial diameter,age,ventricular septal thickness,left ventricular end-systolic diameter and uric acid were 0.836(95%CI:0.788-0.833),0.810(95%CI:0.763-0.857),0.662(95%CI:0.603-0.721),0.649(95%CI:0.590-0.707)and 0.573(95%CI:0.512-0.635),respectively.By selecting a factor with an area>0.7 under the ROC curve,the combined prediction ROC curve of hypertension complicated with paroxytic atrial fibrillation was constructed again,and the combined factor area under the ROC curve was 0.887(95%CI:0.848-0.925).The best sensitivity and specificity for predicting hypertension complicated with paroxysmal atrial fibrillation were found when the age was greater than 59 years and the left atrial diameter was greater than 40 mm.Finally,compare the incidence of high blood pressure level of paroxysmal atrial fibrillation,the incidence of grade 1 hypertension with paroxysmal atrial fibrillation was 19.67%,incidence of grade 2 hypertension with paroxysmal atrial fibrillation was 22.08%,grade 3 hypertension with paroxysmal atrial fibrillation incidence was 30.43%,the incidence of paroxysmal atrial fibrillation between the three groups have no statistical significance(P>0.05).Conclusions1.Increased age,uric acid,left atrial diameter and ventricular septal thickness were the adverse factors for primary hypertension complicated with paroxysmal atrial fibrillation.2.When the age is greater than 59 years old and the left atrial diameter is greater than 40 mm,it has a certain predictive value for paroxysmal atrial fibrillation in patients with primary hypertension.3.There was no statistical significance in the incidence of paroxysmal atrial fibrillation among patients with different levels of primary hypertension.