Treatment of Hypertension to Prevent Atrial Fibrillation

Author(s): De Becker Benjamin*, Van de Borne Philippe.

Journal Name: Current Pharmaceutical Design

Volume 24 , Issue 37 , 2018

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Abstract:

Atrial fibrillation (AF) and hypertension (HT) are expected to rapidly rise worldwide in the next few years. Important improvements in AF therapy are hampered by pro-arrhythmic and bleeding risks of current medications. Prevention of AF is an important matter as it will not only prevent the disease but also medications side effects, and it is likely to be cost effective. HT is a major contributor to AF. As a modifiable risk factor, its treatment might reduce new-onset AF, and recurrent AF after cardioversion or ablation as well. We review here the effect of HT treatment to prevent AF. Renin-angiotensin system (RAS) blockers prevent new-onset AF in patients at high cardiovascular risk, and especially so in heart failure patients. The evidence is less strong among hypertensive patients, except in the presence of left ventricular hypertrophy or if at high cardiovascular risk. In such circumstances, losartan or valsartan were more effective than atenolol or amlodipine. After medical or electrical cardioversion, RAS blockers favourably affect AF recurrence and this class of drug should figure among the prescribed antihypertensive medications. Last, the addition of renal denervation to pulmonary vein isolation may provide even further therapeutic opportunities in patients with refractory HT and AF.

Keywords: Renin-angiotensin system blockade, high cardiovascular risk, heart failure, losartan, valsartan, atenolol, amlodipine, renal denervation.

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Article Details

VOLUME: 24
ISSUE: 37
Year: 2018
Page: [4397 - 4403]
Pages: 7
DOI: 10.2174/1381612825666181127100437
Price: $58

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