Prevalence, clinical correlates and treatment of permanent atrial fibrillation among the elderly: insights from the first prospective population-based study in rural Greece.

To investigate the prevalence of permanent atrial fibrillation (AF), its clinical associated conditions and treatment status in the elderly population in rural Greece. 720 people (46.1% males) older than 65 years (mean age: 72.5 +/- 5.7 years) living in four villages in rural Greece were screened with an electrocardiogram (response rate: 90.5%) for the presence of permanent AF. They underwent a physical examination, including blood pressure (BP) measurement, and body mass index (BMI) calculation, in addition to an interview about their medical history, physical activity, smoking habits, alcohol consumption and medication use. Subjects with AF for whom anticoagulants were contraindicated were identified and stroke risk stratification was performed using the CHADS2 algorithm. The prevalence of permanent AF was 5% (6.6% among men and 3.6% among women) and it increased with age. In the entire population, ECG evidence of myocardial ischaemia and ventricular premature beats were independently associated with the presence of permanent AF (OR 5.266; 95% CI 2.22-12.49, P = 0.0001 and OR 2.61; 95% CI 1.059-6.432, P = 0.037, respectively), while female sex was independently associated with the absence of the AF (OR 0.327; CI 0.147-0.729, P = 0.006). From those patients who were eligible for anticoagulation, 40.6% were treated with anticoagulants, 34.3% were given antiplatelets therapy and the rest received no antithrombotic treatment. This is the first prospective study demonstrating the prevalence, clinical correlates and treatment status of permanent AF in Greece. These results confirm the high prevalence of permanent AF among the elderly and underscore the issue regarding anticoagulants underutilization.

Gender-specific differences in hypertension prevalence, treatment, control, and associated conditions among the elderly: data from a Greek population.

PURPOSE: In the present study we sought to assess the gender-specific prevalence, treatment rates, and control of hypertension, as well as to identify its associated conditions and additional cardiovascular (CV) risk factors, in a Greek population aged > or = 65 years old. METHODS: This is a population-based study including a clinical interview, an ECG recording, and blood pressure (BP) measurements by sphygmomanometer. RESULTS: The overall prevalence of hypertension was 83.3%, higher in females and increasing with age. In males, hypertension was independently associated with increased body mass index (BMI), a history of stroke, and myocardial infarction, while in females increased age, BMI, and a history of diabetes were independently associated with hypertension. A considerable proportion of hypertensives were treated (77.3%), while an effective control of BP was achieved in 42.5% of treated subjects. Despite the fact that hypertension treatment rates did not differ between the genders, control rates were lower among females. Finally, more hypertensive females presented additional CV risk factors than normotensives. CONCLUSION: Elderly females exhibit a higher prevalence of hypertension and are characterized by lower hypertension control compared to hypertensive males.

Prevalence of interatrial block in a general population of elderly people.

BACKGROUND: Interatrial block (IAB: P wave > or = 110 ms) is highly prevalent in people > or =65 years old living in a community. METHODS: We investigated 720 consecutive people age > or =65 years old, from the general population, with the intention of evaluating the prevalence of IAB in their electrocardiogram. After excluding 42 people with atrial fibrillation and atrial flutter (5%) or having a permanent pacemaker (0,83%), we evaluated the electrocardiograms of the remaining 678 people with sinus rhythm. RESULTS: We identified 400 (59%) persons with IAB with a similar distribution between men (58.5%) and women (59.4%). IAB was also identified in 347 from a total of 570 hypertensive people (60,9%) and only in 53 out of 108 (49.1%) nonhypertensive people (P = 0.015). CONCLUSIONS: The surprisingly large prevalence of the IAB in the general older population emphasizes the importance of the early recognition of this abnormality from the surface 12-lead electrocardiogram.