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Updated: Oct 2, 2026
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
[Antithrombotic treatment in hypertensive patients with chronic atrial fibrillation. CARDIOTENS 99 study]
Vicente Bertomeu Martínez1, Pedro J Morillas Blasco, José Ramón González Juanatey
1Sección de Cardiología, Hospital Universitario San Juan, Alicante, Spain.
Insights
Hypertensive patients with atrial fibrillation in Spain show suboptimal oral anticoagulation, particularly those managed in primary care. Elderly patients received less anticoagulation and more antiplatelet therapy.
Area of Science:
- Cardiology
- Internal Medicine
- Pharmacology
Context:
- Hypertension and atrial fibrillation (AF) are common comorbidities.
- Effective anticoagulation and antiplatelet therapies are crucial for managing AF patients.
- Daily clinical practice in Spain provides a unique setting to evaluate treatment patterns.
Purpose:
- To assess the utilization of oral anticoagulation and antiplatelet therapy in hypertensive patients with AF in Spain.
- To identify differences in treatment strategies between primary care physicians and cardiologists.
- To analyze treatment variations based on patient demographics and age.
Summary:
- A prospective study of 32,051 outpatients identified 999 (9.46%) with both hypertension and AF.
- Oral anticoagulation was suboptimal (33%), with lower rates in primary care (26%) versus cardiology (41%).
- Oral antiplatelet therapy was used in 39%, with higher rates in primary care for patients under 65.
Impact:
- Highlights a gap in oral anticoagulation for hypertensive AF patients in Spain, especially in primary care.
- Suggests a need for improved guideline adherence and physician education.
- Identifies potential undertreatment in elderly patients, warranting further investigation.
Background:
Our main goals were to know the actual degree of oral anticoagulation and antiaggregation in hypertensive patients with atrial fibrillation in the daily clinical practice in Spain and to analyze any differences between primary care physicians and cardiologists.
Patients And Method:
32,051 outpatients attended the same day by 1,159 physicians (21% cardiologists) were prospectively included in a database taking into account a history of hypertension and atrial fibrillation, demographic data and ongoing treatments.
Results:
Hypertension was detected in 10,555 patients and 999 of them had both hypertension and atrial fibrillation (9.46%: 435 males [44%] and 564 females [56%]). 53% patients were attended by primary care physicians and the rest by cardiologists. 33% of hypertensive patients with atrial fibrillation were on oral anticoagulation: 41% of them attended by cardiologists and 26% by primary care physicians (p < 0.05). These differences persisted when the patients were compared on the basis of their age. 39% of hypertensive patients were on oral antiaggregation treatment, without differences in both groups except for those aged less than 65 years who were found to receive more antiaggregation in primary care (36% vs 24%; p < 0.05).
Conclusions:
The prevalence of atrial fibrillation in hypertensive patients is about 10%; there is a suboptimal degree of utilization of oral anticoagulation, which is more evident in patients attended by primary care physicians; elderly patients (> 80 years-old) were found to receive less anticoagulants and more antiaggregants both in primary health-care and cardiology health-care.
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