title: 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.
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.
authors.affiliation: Department of Cardiology, Asklepeion General Hospital, Athens, Greece. ajmanol@otenet.gr
authors.forename: Athanasios J
authors.initials: AJ
authors.lastname: Manolis
authors.forename: Enrico Agabiti
authors.initials: EA
authors.lastname: Rosei
authors.forename: Antonio
authors.initials: A
authors.lastname: Coca
authors.forename: Renata
authors.initials: R
authors.lastname: Cifkova
authors.forename: Serap E
authors.initials: SE
authors.lastname: Erdine
authors.forename: Sverre
authors.initials: S
authors.lastname: Kjeldsen
authors.forename: Gregory Y H
authors.initials: GY
authors.lastname: Lip
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Narkiewicz
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Parati
authors.forename: Josep
authors.initials: J
authors.lastname: Redon
authors.forename: Roland
authors.initials: R
authors.lastname: Schmieder
authors.forename: Costas
authors.initials: C
authors.lastname: Tsioufis
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mancia
mesh_terms: D001281:Atrial Fibrillation; D005060:Europe / Q000453:epidemiology; D006801:Humans; D006973:Hypertension; D012307:Risk Factors; D012955:Societies, Medical; D013923:Thromboembolism / Q000517:prevention & control