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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Atrial fibrillation: hypertension as a causative agent, risk factor for complications, and potential therapeutic
Jeff S Healey1, Stuart J Connolly
1McMaster University, Hamilton, Ontario, Canada.
Insights
Aggressively treating hypertension may prevent atrial fibrillation (AF) and reduce stroke risk. Managing high blood pressure can reverse cardiac changes that promote AF and its complications.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Atrial fibrillation (AF) and hypertension are common, coexisting conditions increasing with age.
- Hypertension contributes to cardiac structural changes favoring AF development and thromboembolic risk.
- Current AF management prioritizes rate/rhythm control and anticoagulation, not hypertension treatment.
Purpose of the Study:
- To explore the role of hypertension treatment in managing atrial fibrillation.
- To investigate if aggressive hypertension management can prevent AF and its complications.
Main Methods:
- Review of existing literature on the relationship between hypertension and atrial fibrillation.
- Analysis of the impact of hypertension on cardiac structure and physiology.
- Evaluation of potential benefits of pharmacotherapy for AF prevention.
Main Results:
- Hypertension is linked to left ventricular hypertrophy, atrial enlargement, and slowed atrial conduction.
- These cardiac changes increase AF incidence and thromboembolic risk.
- Aggressive hypertension treatment may reverse structural changes and reduce AF occurrence.
Conclusions:
- Hypertension management is crucial for preventing atrial fibrillation and its complications.
- Pharmacotherapy targeting hypertension could be key in primary and secondary AF prevention.
- Integrating aggressive blood pressure control into AF management strategies is warranted.
Abstract:
Atrial fibrillation and hypertension are 2 prevalent, and often coexistent, conditions in the North American population. Their incidence increases with advancing age, and they are responsible for considerable morbidity and mortality. Although the relation between the 2 conditions has long been known, the treatment of hypertension is not currently a focus in the clinical management of atrial fibrillation. Hypertension is associated with left ventricular hypertrophy, impaired ventricular filling, left atrial enlargement, and slowing of atrial conduction velocity. These changes in cardiac structure and physiology favor the development of atrial fibrillation, and they increase the risk of thromboembolic complications. Conventional therapy of atrial fibrillation has focused on interventions to control heart rate and rhythm and the prevention of stroke through the use of anticoagulant medications. In patients with atrial fibrillation, aggressive treatment of hypertension may reverse the structural changes in the heart, reduce thromboembolic complications, and retard or prevent the occurrence of atrial fibrillation. Specific pharmacotherapy could potentially play a major role in the primary and secondary prevention of atrial fibrillation and its complications.
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