Epidemiological and clinical research has confirmed a link between obesity and depressive symptoms, with inflammation as a potential common mechanism. Given that dietary components modulate inflammation and relate to both conditions, investigating dietary inflammation as a potential underlying pathway is necessary. Herein, we aimed to explore the potential role of the Energy-adjusted Dietary Inflammatory Index (E-DII) in explaining the relationship between obesity and depressive symptoms. We conducted a cross-sectional analysis of the 2007-2018 National Health and Nutrition Examination Survey cohort, enrolling 20 324 participants. Obesity and dietary inflammation were assessed by BMI and E-DII, respectively. Depressive symptoms were evaluated using the nine-item Patient Health Questionnaire-9. We found that obesity and inflammatory diets were positively associated with depressive symptoms (β = 0·50, 95 % CI 0·30, 0·69; β = 0·35, 95 % CI 0·19, 0·50; both P < 0·001), and variations in the association among obesity, pro-inflammatory diets and depressive symptoms were evident across various population subgroups (e.g. sex, age, chronic diseases and smoking status subgroups, Pfor interaction < 0·050). After adjusting for all covariates, E-DII accounted for 4 % of the obesity-depression association. Despite this modest proportion, the finding identifies dietary-induced inflammation as a statistically significant, modifiable pathway. In conclusion, obesity and pro-inflammatory diets are linked to an increased risk of depressive symptoms, with E-DII serving as a modest but significant modifiable pathway. These findings highlight dietary intervention as a potential strategy for mitigating depressive symptoms in individuals with obesity.

Concerns regarding neuropsychiatric adverse events (NPAEs), including depression and suicidality, have emerged with the expanding use of GLP-1-based therapies across metabolic and weight-management indications. This study aimed to characterize neuropsychiatric adverse-event reporting patterns for GLP-1-based therapies in VigiBase using disproportionality analysis. Individual case safety reports entered into the WHO global pharmacovigilance database (VigiBase) from inception through 31 January 2025 were examined. Disproportionality analysis using the information components and the reporting odds ratio was conducted to identify putative safety signals. The full VigiBase reporting background during the study period was used as the comparator. We described the drug-event pairs, mapped signal overlap across agents, evaluated the relationship between reporting frequency and signal magnitude, and conducted stratified analyses by sex and age. Among 899 280 GLP-1RAs-related reports, 19 811 (2.2

BACKGROUND:The optimal threshold or range for systolic blood pressure (SBP) control in patients with successful reperfusion after endovascular thrombectomy for acute ischemic stroke (AIS) remains undefined. This study investigated whether SBP within the first 24 hours after successful reperfusion correlates with functional outcomes in AIS. METHODS:In this secondary analysis of the ENCHANTED2/MT trial, patients were categorized into two groups (120-140 mm Hg and 140-180 mm Hg, respectively) based on achieved SBP within 24 hours after randomization. The primary outcome was the modified Rankin Scale (mRS) score at 90 days. Secondary outcomes included neurological deterioration at 7 days, major disability (mRS score of 3-5 at 90 days), hospitalization duration, and health-related quality of life assessed by the three-level EuroQoL 5-Dimension Self-Report Questionnaire (EQ-5D-3L) at 90 days. Safety outcomes included early neurological decline (END), 90-day mortality, symptomatic intracranial hemorrhage (sICH), and any intracranial hemorrhage (ICH). Treatment effects were expressed as ORs with 95% confidence intervals (CIs). RESULTS:A total of 611 patients (363 in the 120-140 mm Hg group and 248 in the 140-180 mm Hg group) were included. The mean (SD) age was 67 (12) years and 37.8% were female. After adjusting for confounders, the 120-140 mm Hg group was significantly associated with better functional outcomes (mRS: 2 (IQR 1-4) vs 2 (IQR 1-5); adjusted OR 1.54 (95% CI 1.10 to 2.17), P=0.013). Compared with the 140-180 mm Hg group, the 120-140 mm Hg group had lower rates of neurological deterioration at 7 days (adjusted OR 0.68 (95% CI 0.47 to 0.98), P=0.037) and 90-day mortality (47 (13.0%) vs 53 (21.4%); adjusted OR 0.48 (95% CI 0.27 to 0.86), P=0.013). There were no significant differences between groups in END, major disability at 90 days, hospitalization duration, EQ-5D-3L score, sICH, or ICH (all P>0.05). CONCLUSIONS:In patients with successful reperfusion after endovascular thrombectomy, an average SBP within 24 hours of 120-140 mm Hg was associated with a greater likelihood of functional independence compared with 140-180 mm Hg.

Background Current hypertension guidelines recommend either ambulatory or home blood pressure (BP) monitoring for the management of hypertension. How we should properly utilize these 2 out-of-office BP measurement techniques remains under investigation. Objectives The purpose of this study was to investigate ambulatory and home BP monitoring in the definition of BP phenotypes with regard to cardiovascular outcomes. Methods In a nationwide prospective cohort, baseline observations were collected from August 2009 to October 2017, with last follow-ups in July 2024. Results Among 4,935 participants (mean age 54.3 years), median follow-up time was 4.9 years. The incidence rate of all cardiovascular events (n = 256), stroke (n = 100), and cardiac events (n = 171) was significantly (P ≤ 0.001) higher in 2,894 treated (14.9, 5.9, and 9.7 per 1,000 person-years, respectively) than 2,041 untreated outpatients (4.5, 1.4, and 3.2 per 1,000 person-years, respectively). In untreated patients, the analyses adjusted for confounders and mutually one for another out-of-office BP measurement technique showed that ambulatory but not home (masked and sustained) hypertension was associated with a higher risk of cardiac events relative to normotension (HR: 9.01; 95% CI: 1.10-73.91; and HR: 9.74; 95% CI: 1.01-94.25, respectively). In treated patients, the similarly adjusted analyses showed that home but not ambulatory sustained uncontrolled hypertension was associated with a higher risk of all cardiovascular events (HR: 1.80; 95% CI: 1.12-2.92; P = 0.02) and stroke (HR: 2.32; 95% CI: 1.00-5.42; P = 0.05) relative to controlled hypertension. Conclusions Our study in young and middle-aged outpatients indicates a preferable role of ambulatory and home BP monitoring, respectively, in untreated and treated patients in cardiovascular prediction.

Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) are key therapies for type 2 diabetes and obesity, regulating blood glucose by mimicking endogenous GLP-1. Despite efficacy, GLP-1 RAs are associated with adverse reactions across multiple organ systems. To address the gap in class-wide comparative safety analyses beyond previous studies limited to single drugs or organ systems, this study systematically evaluated adverse events for all approved GLP-1 RAs to identify hidden risks and support clinical decision-making. We conducted a disproportionality analysis using the World Health Organization pharmacovigilance database (VigiBase) data up to January 2025. Reporting odds ratio (ROR) and information component (IC) were calculated for seven GLP-1 RAs. Signals were considered significant when ROR025 > 1 and IC025 > 0. Subgroup analyses were stratified by gender and age. We aimed to synthesize and analyze existing randomized controlled trials (RCT) to validate VigiBase mining results. Among 348,649 reports, gastrointestinal disorders were the most frequent System Organ Class. Notable signals included tirzepatide with “abdominal pain” (ROR025 = 53.54), liraglutide with “drug ineffective” (ROR025 = 31.14) and “pancreatitis” (ROR025 = 4.24), exenatide with “injection site pain” (ROR025 = 70.14), and albiglutide with “device use error” (ROR025 = 1424.33). Male patients and younger adults (18–44 years) generally showed higher positive reporting rates. This study provides a comprehensive safety comparison across all seven approved GLP-1 RAs, confirming known risks and revealing drug-specific signals—such as injection-related issues and paradoxical hyperglycemia. These findings aid personalized treatment strategies and post-marketing surveillance.

BACKGROUND:The association between nonalcoholic fatty liver disease (NAFLD) and atrial fibrillation (AF) remains controversial. AIMS:This study aimed to investigate the potential relationship between NAFLD and AF risk, utilizing data from the UK Biobank. METHODS:In this large-scale population-based cohort study, participants without a history of AF were captured from the UK Biobank from 2006 to 2010. NAFLD was identified using a fatty liver index threshold of ≥60. Cox regression models with progressive covariate adjustment were employed. Propensity score matching and competing risk models were utilized in sensitivity analysis. Subgroup analyses were performed to explore potential heterogeneity in the association. RESULTS:Overall, 92 581 participants (47.6% male, median [interquartile range] age, 53.00 [47.00-58.00] years, 30 972 [33.5%] NAFLD, 61 609 [65.5%] non-NAFLD) were included at baseline. During a median follow-up of 12.88 years, 1633 new-onset AF were diagnosed in NAFLD (5.27%), while 1583 new-onset AF were diagnosed in non-NAFLD (2.57%). Incidence curves showed that the incidence of new-onset AF was consistently higher in NAFLD participants throughout the observation period. However, in the fully-adjusted multivariable Cox regression model, this association was markedly attenuated and no longer significant (hazard ratio, 0.93; 95% confidence interval, 0.84-1.02; P = 0.12). Sensitivity and subgroup analyses yielded results largely consistent with the primary findings. CONCLUSIONS:In this large cohort study from the UK Biobank, NAFLD was not an independent risk factor for AF. This implies that the increased incidence of AF observed in participants with NAFLD may be more closely related to cardiometabolic risk factors contributing to the development of NAFLD rather than the condition itself.

OBJECTIVE:This study investigated the exercise-induced changes in blood pressure (BP) and pulse rate using a wearable oscillometric BP monitor and their associations with cardiac structure and function. METHODS:The study included 137 participants (mixed hypertensive and normotensive) who underwent standardized symptom-limited cycle ergometer testing. BP and pulse rate were measured at rest, at peak exercise, and during recovery using HUAWEI WATCH D2, with reserves calculated as the peak minus rest values. Cardiac structure and function were assessed by echocardiography. RESULTS:The study participants had a mean age of 36.7 years, and included 63 women (46.0%) and 69 patients with hypertension (50.4%). During exercise, SBP rose by 31.7 (± 17.5) mmHg (from 119.9 mmHg at basal to 151.7 mmHg at maximal), DBP by 4.9 (± 9.4) mmHg (from 79.0 to 84.0 mmHg), and pulse rate by 62.8 (± 18.6) beats/min (from 81.4 to 149.6 beats/min). After adjustment, SBP reserve was significantly associated with cardiac structure ( P  ≤ 0.024), but only with stroke volume ( P =0.048) among the functional measurements ( P  ≥ 0.443). Pulse rate reserve were negatively associated with cardiac structural measurements ( P  ≤ 0.046), and positively with diastolic function ( P  ≤ 0.048). These observed associations tended to be stronger in women. CONCLUSION:Wearable BP monitors can trace hemodynamic responses to exercise. The exercise-induced changes in pulse rate and SBP are associated with cardiac structure and function, especially in women.

BackgroundThe choice of anesthesia modality during mechanical thrombectomy (MT) for acute ischemic stroke remains debated. This study aimed to analyze the impact of anesthesia type on clinical outcomes following endovascular therapy (EVT).MethodsThis subgroup analysis of the ENCHANTED2/MT trial included patients with large vessel occlusion (LVO) acute ischemic stroke who achieved successful reperfusion (eTICI ≥2b). Patients were stratified by anesthesia type: general anesthesia (GA) or non-general anesthesia (Non-GA). The primary outcome was functional recovery, assessed by the distribution of scores on the modified Rankin Scale (mRS; range 0 [no symptoms] to 6 [death]) at 90 days. Efficacy was analyzed using ordinal logistic regression.ResultsA total of 809 patients were included (GA: 344; Non-GA: 465). There was no significant between-group difference in the primary outcome of mRS score distribution. The incidence of postoperative pneumonia was significantly lower in the Non-GA group (adjusted odds ratio [aOR] 0.33, 95% CI 0.14–0.74; p = 0.008). Among patients with milder initial neurological deficits (admission NIHSS score <15), the Non-GA group had higher odds of achieving functional independence (mRS 0–2) at 90 days (aOR 1.71, 95% CI 1.00–2.91; p = 0.049); this association was not observed in patients with more severe deficits (NIHSS ≥15) (P for interaction = 0.05). No significant differences were found between groups in the rates of symptomatic intracranial haemorrhage, recurrent stroke, mortality, or in the level of reperfusion.ConclusionIn patients undergoing mechanical thrombectomy for acute ischemic stroke, Non-GA may be associated with better functional outcomes in patients presenting with milder neurological deficits. GA was associated with an increased risk of postoperative pneumonia.

Hydrogen sulfide (H2S) has been shown to alleviate bone and joint inflammation in osteoarthritis (OA). Exploring the connection between H2S and OA could reveal novel therapeutic avenues for treating this condition. This study utilized H2S as the exposure variable and OA as the outcome within a Mendelian randomization framework. Data for genome-wide association studies related to both exposure and outcome were sourced from the IEU OpenGWAS project. To estimate causal relationships, inverse variance weighted method was employed, along with supplementary analytical techniques (MR-Egger, weighted median, simple mode, and weighted mode), and sensitivity studies were carried out to evaluate our results' dependability. The inverse variance weighted analysis revealed that the abundance of a specific gut bacterial pathway involved in the reduction process of sulfate "SO4ASSIM.PWY..sulfate.reduction.I..assimilatory." acts as a protective factor against hospital-diagnosed knee osteoarthritis, with an odds ratio of 0.687 (95% confidence interval = 0.479-0.987, P = .042). In contrast, gut bacterial pathway abundance associated with sulfate assimilation and cysteine biosynthesis "SULFATE.CYS.PWY..superpathway.of.sulfate.assimilation.and.cysteine.biosynthesis" was linked to increased risk for hospital-diagnosed OA, showing an odds ratio value of 1.120 (95% confidence interval = 1.000-1.255, P = .049). Sensitivity analyses validated the strength of the causal relationship between the gut bacterial pathway abundance and OA. We identified that the gut bacterial pathway abundance associated with H2S "SO4ASSIM.PWY..sulfate.reduction.I..assimilatory." acts as a protective factor for OA suggesting its potential role in OA treatment and offering new avenues for research on H2S in the treatment of OA in this context.

Abstract Background and aims Whether baseline stroke severity modifies the effect of intravenous thrombolysis (IVT) prior to endovascular treatment (EVT) in patients with acute anterior circulation large vessel occlusion (LVO) is uncertain, particularly regarding the risk of intracranial hemorrhage in severe strokes. We aim to assess the heterogeneity of IVT prior to EVT on clinical outcomes based on baseline NIHSS scores. Methods Two thousand three hundred thirteen patients with anterior circulation LVO who presented directly to EVT-capable centers from six randomized-controlled trials were analyzed. In the primary analysis, effect modification of IVT prior to EVT by baseline NIHSS scores was assessed using multivariable ordinal regression with interaction terms. Secondary analyses evaluated the heterogeneity of IVT prior to EVT by different time windows in severe stroke patients. Results There was no statistically significant effect modification of IVT prior to EVT on the functional outcome by baseline NIHSS scores (adjusted p-interaction = 0.579). For severe stroke patients, there was no effect heterogeneity of IVT prior to EVT on the complication of any hemorrhage by different time windows (adjusted p-interaction = 0.500 and 0.508 for NIHSS > 25; p-interaction = 0.819 and 0.408 for and NIHSS ≥ 20, respectively). Conclusions Among patients with acute anterior circulation LVO presenting directly to EVT-capable centers within 4.5 hours, there is no evidence to suggest that stroke severity can direct the decision-making process for administering IVT prior to EVT. For severe stroke patients, IVT prior to EVT did not significantly increase the risk of hemorrhagic transformation, regardless of the time window. Conflict of interest

BackgroundChimeric antigen receptor (CAR) T-cell therapy is increasingly used for hematologic malignancies, yet the spectrum and clinical significance of its endocrine adverse events (AEs) remain poorly characterized.ObjectiveTo identify and clinically contextualize signals of endocrine AEs associated with CAR T-cell therapy, with a focus on their overlap with cytokine release syndrome (CRS).MethodsWe performed a retrospective disproportionality analysis using the FDA Adverse Event Reporting System (FAERS) database (2017 to Q2 2025). Reporting odds ratio (ROR) and information component (IC) were calculated for endocrine AEs associated with six CAR T-cell products. To validate and elaborate these pharmacovigilance signals, a structured literature review was conducted to identify published clinical evidence.ResultsThe FAERS analysis identified 269 endocrine AE reports, yielding 14 significant disproportionality signals. Hyperglycemia was the most frequently reported event, while estrogen deficiency showed the strongest signal strength (ROR₀₂₅ = 14.93). Signals for adrenal insufficiency and hypothalamo-pituitary disorders were primarily associated with axicabtagene. Critically, mortality was frequently reported among cases with positive endocrine signals, particularly when the endocrine AE co-occurred with CRS. The literature review provided direct clinical validation: a retrospective study confirmed a 39% incidence of CRS-associated hyperglycemia, and independent case reports documented the first instances of CAR T-cell therapy-induced Hashimoto’s thyroiditis and central diabetes insipidus. These clinical cases corroborated the FAERS signals and suggested immune-inflammatory mechanisms, often independent of corticosteroid use.ConclusionThis integrated analysis reveals a distinct spectrum of CAR T-cell-related endocrine toxicities, encompassing glucose and calcium dysregulation, pituitary axis disorders, and autoimmune phenomena. The frequent and potentially fatal overlap with CRS underscores the need for enhanced clinical vigilance. Proactive monitoring of endocrine function, especially in patients experiencing CRS, is warranted to mitigate these underrecognized complications.

e17523 Background: Cervical cancer is the most prevalent malignant neoplasm of the female reproductive system. China accounts for close to 1/5 of the world's incidence cases. The physical, psychological, and social life issues that accompany cervical cancer treatment are what physicians need to focus on. Methods: This study prospectively recruited patients who underwent surgical for cervical cancer at 7 regional medical centers in China between July 2021 and December 2023. Subjects were followed up on the CC-PRO137 (Cervical Cancer Patient Reported Clinical Outcome Assessment Scale) scale at two time points: within 6 months after the end of treatment and after 12 months period. Physical and psychological functioning and social life status of the patients were investigated. Subjects' recovery status was compared across conditions, and differences in their quality of life were analyzed and compared using multiple linear regression equations. Results: A total of 368 subjects were followed up for 2 time periods. In physiological field, the patient's urinary function is most affected in the short term. Relative to open surgery, patients undergoing laparoscopic surgery were more severely impaired in urinary function (URI: t=-2.985, p=0.023), lymphedema status (LYM: t=-2.465, p=0.014) and neurological function (NEU: t=-2.996, p=0.003). Laparoscopic surgery increases patients' social support burden (SUP: t=-2.016, p=0.044). In psychological field, radiotherapy exacerbated symptoms of anxiety and depression, as well as feelings of shame associated with the disease (ANX: t=-2.256, p=0.025; DEP: t=-2.295, p=0.022; SHA: t=-2.674, p=0.008). Social lives are only affected by the patient's age (LIF: t=-4.677, p=0.000). After 12 months, the impact of radiotherapy on bowel function (BOW: t=-2.044, p=0.042) and sexual life (SEX: t=-2.705, p=0.007) was found to be enduring. Conclusions: Clinicians should grasp the feedback of patients' recovery outside the hospital, so as to be able to give more immediate and targeted help to patients. Furthermore, for patients, cognisance of potential outcomes can facilitate more effective management of expectations.

Purpose: Previous studies have shown a conflicting association between body mass index and myopia. This study aimed to analyze the possible association between Body Mass Index (BMI) and myopia in the observational design and genetic evidence.Methods: In the observational investigation, 5,710 participants (12-25 years) from the 2001-2006 National Health and Nutrition Examination Survey (NHANES) were included. Weighted logistic regression models, restricted cubic spline (RCS) and stratified analysis were conducted in the NHANES. A two-sample Mendelian Randomization (MR) study using Genome-Wide Association Studies (GWAS) summary statistics and GWAS catalog was performed. The inverse-variance weighted (IVW) method was used as the main analysis method, and the sensitivity analysis was performed to detect pleiotropy and heterogeneity bias.Results: In the fully adjusted model, individuals with obesity had a higher risk of myopia [OR = 1.253, 95% CI= (1.049, 1.496), p = 0.014] and mild and moderate myopia [OR = 1.305, 95% CI= (1.094, 1.558), p = 0.004]. BMI was correlated with refractive spherical equivalent and showed a linear relationship (P for nonlinearity = 0.468, p = 0.002,β=-0.016). In males, obesity had an association with myopia, while there was no statistical significance in females. In the subgroup with an education level of < 9th Grade, obesity and myopia exhibited consistent results. Two-sample MR showed that obesity had no statistically significant with myopia and refractive error.Conclusions: This study suggests that the associations between BMI and the risk of myopia differ based on gender and education levels in an observational study, while there are no associations in genetic evidence.

OBJECTIVES:There is some preclinical evidence suggesting a pro-inflammatory diet reduces kidney function. In the present study, we aimed to investigate the association of inflammatory potential of diet with the risk of chronic renal failure (CRF). METHODS:Cox regression models were used to examine the association between the energy-adjusted dietary inflammation index (E-DII) quartiles and CRF adjusting varying degrees of confounders. Restricted cubic spline regression was additionally adopted to determine the association of the continuous E-DII and CRF risk. A series of sensitivity and subgroup analyses were also conducted. RESULTS:A total of 163,433 participants entered the primary analysis. During a mean follow-up period of 12.65 years, incident CRF occurred in 5, 333 participants (3.26%). The E-DII scores was stratified into four quartile groups. In a fully adjusted multivariable model, the adjusted hazard ratio for the second, third, and highest quartiles of E-DII intake was 1.12 (95% confidence interval [CI]: 1.04-1.21), 1.21 (95% CI: 1.12-1.31), and 1.23 (95% CI: 1.14-1.33), respectively, compared with the lowest quartile. Trend test indicated a statistically significant increasing trend with increasing E-DII quartiles (P < 0.0001). Similarly, restricted cubic spline regression displayed a positive association of continuous E-DII with CRF, wherein higher scores were linked to an elevated risk of CRF. Results of sensitivity analyses demonstrated consistent findings. CONCLUSIONS:Diet with higher proinflammatory potential was linked to an increased risk of CRF. Implementing measures to limit the intake of pro-inflammatory foods or promoting the adoption of an anti-inflammatory dietary pattern could potentially reduce the occurrence of CRF.

In the present analysis, we investigated the association between alcohol consumption and ambulatory blood pressure (BP) control in male patients after 8 weeks of antihypertensive therapy with two dihydropyridine calcium channel blockers. The study participants were hypertensive (clinic systolic/diastolic BP of 140-179/90-109 mmHg and 24-hour ambulatory systolic/diastolic BP ≥ 130/80 mmHg) patients enrolled in a randomized controlled trial and treated with amlodipine 5–10 mg or nifedipine gastrointestinal therapeutic system (GITS) 30–60 mg once daily. Alcohol consumption was classified as non-drinkers and drinkers. Non-dipping was defined as a BP drop from daytime to nighttime <10 Alcohol drinkers had higher nighttime systolic and diastolic blood pressure than non-drinkers at baseline. Clinic blood pressure-guided antihypertensive treatment was insufficient in changing the non-dipping to dipping pattern in alcohol drinkers with sustained clinic and ambulatory hypertension.

BACKGROUND Atrial fibrillation (AF) is a common cardiac arrhythmia in the elderly. This study aimed to evaluate urban-rural disparities in its prevalence and management in elderly Chinese.METHODS Consecutive participants aged ≥ 65 years attending outpatient clinics were enrolled for AF screening using handheld single-lead electrocardiogram (ECG) from April 2017 to December 2022. Each ECG rhythm strip was reviewed from the research team. AF or uninterpretable single-lead ECGs were referred for 12-lead ECG. Primary study outcome comparison was between rural and urban areas for the prevalence of AF. The Student’s t-test was used to compare mean values of clinical characteristics between rural and urban participants, while the Pearson’s chi-square test was used to compare between-group proportions. Multivariate stepwise logistic regression analysis was performed to estimate the association between AF and various patient characteristics.RESULTS The 29,166 study participants included 13,253 men (45.4%) and had a mean age of 72.2 years. The 7073 rural participants differed significantly (P ≤ 0.02) from the 22,093 urban participants in several major characteristics, such as older age, greater body mass index, and so on. The overall prevalence of AF was 4.6% (n = 1347). AF was more prevalent in 7073 rural participants than 22,093 urban participants (5.6% vs. 4.3%, P < 0.01), before and after adjustment for age, body mass index, blood pressure, pulse rate, cigarette smoking, alcohol consumption and prior medical history. Multivariate logistic regression analysis identified overweight/obesity (OR = 1.35, 95% CI: 1.17–1.54) in urban areas and cigarette smoking (OR = 1.62, 95% CI: 1.20–2.17) and alcohol consumption (OR = 1.42, 95% CI: 1.04–1.93) in rural areas as specific risk factors for prevalent AF. In patients with known AF in urban areas (n = 781) and rural areas (n = 338), 60.6% and 45.9%, respectively, received AF treatment (P < 0.01), and only 22.4% and 17.2%, respectively, received anticoagulation therapy (P = 0.05).CONCLUSIONS In China, there are urban-rural disparities in AF in the elderly, with a higher prevalence and worse management in rural areas than urban areas. Our study findings provide insight for health policymakers to consider urban-rural disparity in the prevention and treatment of AF.