Abstract
Atrial fibrillation (AF) is the most common sustained arrhythmia, and its prevalence is 1–2% of the general population worldwide. It is expected that its incidence will increase up to 2.5-fold over the next 50 years. There are many risk factors responsible for the development of AF, but hypertension is the most common factor encountered in clinical practice. Hypertension is associated with 1.8-fold increased risk of developing new-onset AF and 1.5-fold risk of progression to permanent AF, while it is likely to be also a reversible causative factor of AF. Untreated or suboptimal treated hypertension which leads to left ventricular hypertrophy on the one hand and atrial remodeling on the other may facilitate the initiation and perpetuation of AF. Many studies have investigated the role of the antihypertensive drug classes either in primary or in secondary prevention of AF, with various results. In this chapter, an assessment of the strong relationship of arterial hypertension with AF, of the pathophysiological mechanisms linking those two diseases, as well as of the effects of various antihypertensive drug classes on AF is undertaken.
References
Davis RC, Hobbs FD, Kenkre JE et al (2012) Prevalence of atrial fibrillation management: a prospective survey in the general population and in high-risk groups: the ECHOES study. Europace 14:1553–1559
Wilke T, Groth A, Mueller S et al (2013) Incidence and prevalence of atrial fibrillation: an analysis based on 8.3 million patients. Europace 15:486–493
Knecht S, Oelschläger C, Duning T et al (2008) Atrial fibrillation in stroke-free patients is associated with memory impairment and hippocampal atrophy. Eur Heart J 29:2125–2132
Santageli P, Di Biase L, Bai R et al (2012) Atrial fibrillation and the risk of incident dementia: a meta-analysis. Heart Rhythm 9:1761–1768
Wolf PA, Abbott RD, Kannel WB (1991) Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke 22:983–988
Wong ND, Lopez VA, L’Italien G et al (2007) Inadequate control of hypertension in US adults with cardiovascular disease comorbidities in 2003–2004. Arch Intern Med 167:2431–2436
Manolis AJ, Rosei EA, Coca A et al (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. J Hypertens 30:239–252
Vaziri SM, Larson MG, Lauer MS et al (1995) Influence of blood pressure on left atrial size. The Framingham Heart Study. Hypertension 25:1155–1160
Mitchell GF, Vasan RS, Keyes MJ et al (2007) Pulse pressure and risk of new-onset atrial fibrillation. JAMA 297:709–715
Van Gelder IC, Hemels ME (2006) The progressive nature of atrial fibrillation: a rationale for early restoration and maintenance of sinus rhythm. Europace 8:943–949
Allessie M, Ausma J, Schotten U et al (2005) Electrical, contractile and structural remodeling during atrial fibrillation. Cardiovasc Res 54:230–246
Penado S, Cano M, Acha O et al (2003) Atrial fibrillation as a risk factor for stroke recurrence. Am J Med 114:206–210
Bunch TJ, Weiss JP, Crandall BG et al (2010) Atrial fibrillation is independently associated with senile, vascular, and Alzheimer’s dementia. Heart Rhythm 7:433–437
Mant J, Fitzmaurice DA, Hobbs FD et al (2007) Accuracy of diagnosing atrial fibrillation on electrocardiogram by primary care practitioners and interpretative diagnostic software: analysis of data from screening for atrial fibrillation in the elderly (SAFE) trial. BMJ 335:380
EHRA, EACTS, Camm AJ, Kirchhof P, Lip GY et al (2010) Guidelines for the Management of Atrial Fibrillation: the task force for the management of atrial fibrillation of the European Society of Cardiology (ESC). Eur Heart J 31:2369–2429
Manolis AJ, Kallistratos MS, Poulimenos LE (2012) Recent clinical trials in atrial fibrillation in hypertensive patients. Curr Hypertens Rep 4:350–359
Ogunsua AA, Shaikh AY, Ahmed M, McManus DD (2015) Atrial fibrillation and hypertension: mechanistic, epidemiologic, and treatment parallels. Methodist Debakey Cardiovasc J 11(4):228–234
Wachtell K, Lehto M, Gerdts E et al (2005) Angiotensin II receptor blockade reduces new-onset atrial fibrillation and subsequent stroke compared to atenolol: the losartan intervention for end point reduction in hypertension (LIFE) study. J Am Coll Cardiol 45:712–719
Jibrini MB, Molnar J, Arora RR (2008) Prevention of atrial fibrillation by way of abrogation of the renin-angiotensin system: a systematic review and meta-analysis. Am J Ther 15(1):36–43
Yusuf S, Diener HC, Sacco RL et al (2008) PRoFESS study Group. Telmisartan to prevent recurrent stroke and cardiovascular events. N Engl J Med 359:1225–1237
Telmisartan Randomised AssessmeNt Study in ACE iNtolerant Subjects with Cardiovascular Disease (TRANSCEND) Investigators, Yusuf S, Teo K, Anderson C et al (2008) Effects of the angiotensin-receptor blocker Telmisartan on cardiovascular events in high-risk patients intolerant to angiotensin-converting enzyme inhibitors: a randomized controlled trial. Lancet 372:1174–1183
ACTIVE Writing Group of the ACTIVE Investigators, Connolly S, Pogue J, Hart R et al (2006) Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the atrial fibrillation Clopidogrel trial with Irbesartan for prevention of vascular events (ACTIVE W): a randomized controlled trial. Lancet 367:1903–1912
Liebson PR, Amsterdam EA (2009) Ongoing Telmisartan alone and in combination with Ramipril global endpoint trial (ONTARGET): implications for reduced cardiovascular risk. Prev Cardiol 12(1):43–50
Schneider MP, Hua TA, Böhm M et al (2010) Prevention of atrial fibrillation by renin-angiotensin system inhibition a meta-analysis. J Am Coll Cardiol 55(21):2299–2307. doi:10.1016/j.jacc.2010.01.043
Nasr IA, Bouzamondo A, Hulot JS et al (2007) Prevention of atrial fibrillation onset by beta-blocker treatment in heart failure: a meta-analysis. Eur Heart J 28(4):457–462
Schmieder RE, Kjeldsen SE, Julius S et al (2008) Reduced incidence of new-onset atrial fibrillation with angiotensin II receptor blockade: the VALUE trial. J Hypertens 26:403–411
Swedberg K, Zannad F, McMurray JJ et al (2012) Eplerenone and atrial fibrillation in mild systolic heart failure: results from the EMPHASIS-HF (Eplerenone in mild patients hospitalization and SurvIval study in heart failure) study. J Am Coll Cardiol 59:1598–1603
Emdin CA, Callender T, Cao J, Rahimi K (2015) Effect of antihypertensive agents on risk of atrial fibrillation: a meta-analysis of large-scale randomized trials. Europace 17:701–710
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Giannitsi, S., Kallistratos, M.S., Poulimenos, L.E., Manolis, A.J. (2018). Atrial Fibrillation and Hypertension: Two Entities That Usually Coexist. In: Berbari, A., Mancia, G. (eds) Disorders of Blood Pressure Regulation. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-59918-2_17
Download citation
DOI: https://doi.org/10.1007/978-3-319-59918-2_17
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-59917-5
Online ISBN: 978-3-319-59918-2
eBook Packages: MedicineMedicine (R0)