Hypertension and atrial fibrillation: Diagnostic approach, prevention and treatment. Position paper of the Working Group 'Hypertension Arrhythmias and Thrombosis' of the European Society of Hypertension

Athanasios J. Manolis, Enrico Agabiti Rosei, Antonio Coca, Renata Cifkova, Serap E. Erdine, Sverre Kjeldsen, Gregory Y H Lip, Krzysztof Narkiewicz, Gianfranco Parati, Josep Redon, Roland Schmieder, Costas Tsioufis, Giuseppe Mancia

Research output: Contribution to journalArticle

Abstract

Hypertension is the most common cardiovascular disorder and atrial fibrillation is the most common clinically significant arrhythmia. Both these conditions frequently coexist and their prevalence increases rapidly with aging. There are different risk factors and clinical conditions predisposing to the development of atrial fibrillation, but due its high prevalence, hypertension is still the main risk factor for the development of atrial fibrillation. Several pathophysiologic mechanisms (such as structural changes, neurohormonal activation, fibrosis, atherosclerosis, etc.) have been advocated to explain the onset of atrial fibrillation. The presence of atrial fibrillation per se increases the risk of stroke but its coexistence with high blood pressure leads to an abrupt increase of cardiovascular complications. Different risk models are available for the risk stratification and the prevention of thromboembolism in patients with atrial fibrillation. In all of them hypertension is present and is an important risk factor. Antihypertensive treatment may contribute to reduce this risk, and it seems some classes are superior to others in the prevention of new-onset atrial fibrillation and prevention of stroke. Antithrombotic treatment with warfarin is effective in the prevention of thromboembolic events, although quite recently, new classes of anticoagulants that do not require international normalized ratio monitoring have been introduced with promising results.

Original languageEnglish
Pages (from-to)239-252
Number of pages14
JournalJournal of Hypertension
Volume30
Issue number2
DOIs
Publication statusPublished - Feb 2012

Keywords

  • anticoagulants
  • antihypertensive treatment
  • atrial fibrillation
  • hypertension

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Manolis, A. J., Rosei, E. A., Coca, A., Cifkova, R., Erdine, S. E., Kjeldsen, S., Lip, G. Y. H., Narkiewicz, K., Parati, G., Redon, J., Schmieder, R., Tsioufis, C., & Mancia, G. (2012). Hypertension and atrial fibrillation: Diagnostic approach, prevention and treatment. Position paper of the Working Group 'Hypertension Arrhythmias and Thrombosis' of the European Society of Hypertension. Journal of Hypertension, 30(2), 239-252. https://doi.org/10.1097/HJH.0b013e32834f03bf