RESUMO
Objectives: There are limited epidemiological data regarding atrial fibrillation (AF) in hypertensive (HT) Romanian adults. We sought to evaluate AF prevalence trends in the SEPHAR surveys (Study for Evaluation of Prevalence of Hypertension and Cardiovascular Risk in an Adult Population in Romania) during a nine-year interval (2012−2016−2021). Methods: Three consecutive editions of a national epidemiological survey regarding HT included representative samples of subjects stratified by age, gender and area of residence (SEPHAR II-IVin total, 5422 subjects, mean age 48.69 ± 16.65 years, 57.5% (n = 3116) females). A post-hoc analysis of AF prevalence and oral anticoagulation (OAC) rates was performed. AF definition was based on a documented medical history of AF and/or AF documentation by study electrocardiogram. Results: General AF prevalence was 5.5% (n = 297). AF prevalence in HT subjects was 8.9% (n = 209) and has risen since SEPHAR II7.2% (n = 57) and SEPHAR III8.1% (n = 72) to SEPHAR IV11.8% (n = 80), respectively (p = 0.001). AF prevalence has increased in HT males (SEPHAR II5.3% (n = 19), SEPHAR III7.6% (n = 26) and SEPHAR IV11.7% (n = 35) (p = 0.010)) and in HT from urban areas (SEPHAR II7.8% (n = 37), SEPHAR III7.8% (n = 40), SEPHAR IV14.7% (n = 50), p < 0.001). In SEPHAR III-IV, only 19.3% (n = 23) of HT AF patients with OAC indication were anticoagulated. Conclusions: AF prevalence has increased by ~64% in hypertensive Romanian adults between 2012 and 2021. However, anticoagulation strategies may be suboptimal in patients with cardioembolic risk.
