title: A Review of Hypertension Management in Atrial Fibrillation.
abstract: Atrial fibrillation (AF) is one of the commonest arrhythmias in clinical practice and has major healthcare and economic implications. It is a growing epidemic with prevalence all set to double to 12 million by 2050. After adjusting for other associated conditions, hypertension confers a 1.5- and 1.4-fold risk of developing AF, for men and women respectively. Furthermore, in patients with AF, the presence of hypertension has a cumulative effect on the risk of stroke. Growing evidence suggests reversal or attenuation of various structural and functional changes predisposing to AF with the use of antihypertensive medications. Randomized trials have shown major reduction in the risk of stroke and heart failure with blood pressure reduction. However, such trials are lacking in AF patients specifically. The Joint National Committee-8 guidelines have not addressed the threshold or goal BP for patients with known AF. Furthermore, "J-shaped" or "U-shaped" curves have been noted during hypertension management in patients with AF with published data demonstrating worse outcomes in patients with strict BP control to <110/60 mmhg similar to coronary artery disease. In this review, we outline the available literature on management of hypertension in patients with AF as well as the role of individual anti-hypertensive medications in reducing the incidence of AF Fig. 1.
authors.forename: Sidakpal S
authors.initials: SS
authors.lastname: Panaich
authors.forename: Nilay
authors.initials: N
authors.lastname: Patel
authors.forename: Kanishk
authors.initials: K
authors.lastname: Agnihotri
authors.forename: Shilpkumar
authors.initials: S
authors.lastname: Arora
authors.forename: Chirag
authors.initials: C
authors.lastname: Savani
authors.forename: Nileshkumar J
authors.initials: NJ
authors.lastname: Patel
authors.forename: Samir V
authors.initials: SV
authors.lastname: Patel
authors.forename: Rajesh
authors.initials: R
authors.lastname: Sonani
authors.forename: Achint
authors.initials: A
authors.lastname: Patel
authors.forename: Sopan
authors.initials: S
authors.lastname: Lahewala
authors.forename: Vikas
authors.initials: V
authors.lastname: Singh
authors.forename: Badal
authors.initials: B
authors.lastname: Thakkar
authors.forename: Parth
authors.initials: P
authors.lastname: Bhatt
authors.forename: Abhishek
authors.initials: A
authors.lastname: Deshmukh
authors.affiliation: The Everett Clinic, 3901 Hoyt Ave, Everett, WA 98201, United States.
authors.forename: Apurva O
authors.initials: AO
authors.lastname: Badheka
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008297:Male; D012306:Risk; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: ACE Inhibitors/ARBs; Atrial Fibrillation; antihypertensive medications; beta blockers; diuretics; hypertension; management