Hypertension and concurrent arrhythmias.
Hypertension and cardiac arrhythmias commonly coexist in many patients. In this review, we will initially discuss arrhythmogenesis in hypertension, with particular emphasis on atrial and ventricular tachyarrhythmias and sudden cardiac death, whilst in the final part, we will focus our attention on the effects of anti-hypertensive therapies on supra-ventricular and ventricular arrhythmias and on sudden cardiac death prevention. Many patients with atrial fibrillation or frequent premature ventricular contractions have hypertension, and both need to be managed appropriately. Furthermore, hypertensive left ventricular hypertrophy could cause a wide variety of ventricular arrhythmias, which could end in sudden cardiac arrest. Most anti-hypertensive therapies, such as the beta blockers or ACE inhibitors, by slowing or interrupting the progression towards atrial and ventricular remodelling might exert some anti-arrhythmic effect, thus reducing the risk of sudden cardiac death in these patients.
Lombardi
Federico
F
Cardiologia, Dipartimento di Medicina, Chirurgia e Odontoiatria, Osp. San Paolo, University of Milan, Milan, Italy. Federico.Lombardi@unimi.it
Terranova
Paolo
P
D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000150:complications* / Q000188:drug therapy; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D012307:Risk Factors; D013565:Sympatholytics / Q000627:therapeutic use; D013617:Tachycardia, Supraventricular / Q000517:prevention & control; D017180:Tachycardia, Ventricular / Q000517:prevention & control
D000317:Adrenergic alpha-Antagonists; D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004232:Diuretics; D000451:Mineralocorticoid Receptor Antagonists; D013565:Sympatholytics