Abstract
Hypertension (HTN) and chronic kidney disease (CKD) often coexist sharing common pathophysiological factors that both in combination and separately induce fibrotic changes in the heart provoking atrial fibrillation (AF). AF, per se, is associated with a 4- to 5-fold increased risk of stroke and a 2-fold increased risk of all-cause death. The co-existence of AF with HTN and renal dysfunction considerably increases morbidity and mortality. Management of AF in hypertensive patients with CKD is complex and multidisciplinary, since these patients have both a prothrombotic state and a coagulopathy with an increased tendency for bleeding. Novel oral anticoagulants such as dabigatran, rivaroxaban and apixaban offer better efficacy and safety especially in patients without optimal treatment with vitamin K antagonists.
Keywords: Atrial fibrillation, anticoagulants, chronic kidney disease, hypertension.
Current Vascular Pharmacology
Title:Atrial Fibrillation and Chronic Kidney Disease in Hypertension: A Common and Dangerous Triad
Volume: 13 Issue: 1
Author(s): Dimitris Tsiachris, Costas Tsioufis, Patrizio Mazzone, Niki Katsiki and Christodoulos Stefanadis
Affiliation:
Keywords: Atrial fibrillation, anticoagulants, chronic kidney disease, hypertension.
Abstract: Hypertension (HTN) and chronic kidney disease (CKD) often coexist sharing common pathophysiological factors that both in combination and separately induce fibrotic changes in the heart provoking atrial fibrillation (AF). AF, per se, is associated with a 4- to 5-fold increased risk of stroke and a 2-fold increased risk of all-cause death. The co-existence of AF with HTN and renal dysfunction considerably increases morbidity and mortality. Management of AF in hypertensive patients with CKD is complex and multidisciplinary, since these patients have both a prothrombotic state and a coagulopathy with an increased tendency for bleeding. Novel oral anticoagulants such as dabigatran, rivaroxaban and apixaban offer better efficacy and safety especially in patients without optimal treatment with vitamin K antagonists.
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Cite this article as:
Tsiachris Dimitris, Tsioufis Costas, Mazzone Patrizio, Katsiki Niki and Stefanadis Christodoulos, Atrial Fibrillation and Chronic Kidney Disease in Hypertension: A Common and Dangerous Triad, Current Vascular Pharmacology 2015; 13 (1) . https://dx.doi.org/10.2174/1570161112666140519154615
DOI https://dx.doi.org/10.2174/1570161112666140519154615 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
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Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
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