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Blood pressure control versus atrial fibrillation management in stroke prevention

Carmine Savoia1, Lidia Sada, Massimo Volpe

  • 1Clinical and Molecular Medicine Department, Cardiology Unit, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy, carmine.savoia@uniroma1.it.

Current Hypertension Reports
|April 21, 2015
PubMed

Insights

Hypertension and atrial fibrillation significantly increase stroke risk. New oral anticoagulants improve adherence for stroke prevention in non-valvular atrial fibrillation, offering better outcomes than warfarin.

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • Hypertension is a primary risk factor for atrial fibrillation (AF), a common condition in hypertensive patients.
  • Both hypertension and AF independently increase stroke risk, with their combination leading to more disabling strokes.
  • Atrial fibrillation, even if silent, doubles the risk of cardiovascular death, highlighting the need for effective stroke prevention.

Purpose of the Study:

  • To review the association between hypertension and atrial fibrillation regarding stroke risk.
  • To discuss current stroke prevention strategies in hypertensive patients with atrial fibrillation.
  • To highlight the advancements in anticoagulation therapy for non-valvular atrial fibrillation.

Main Methods:

  • Literature review of studies on hypertension, atrial fibrillation, stroke, and anticoagulation.
  • Analysis of the benefits and adherence associated with new oral anticoagulants compared to warfarin.
  • Examination of the impact of blood pressure control and anticoagulation adherence on stroke incidence.

Main Results:

  • Despite recommendations, many hypertensive patients do not reach blood pressure goals.
  • New oral anticoagulants offer improved adherence for long-term anticoagulation in non-valvular atrial fibrillation.
  • Non-adherence to stroke prevention medications is a significant risk factor for both initial and recurrent strokes.

Conclusions:

  • Effective blood pressure management is crucial for primary stroke prevention in hypertensive individuals.
  • Advances in anticoagulation, particularly new oral anticoagulants, improve therapeutic adherence and stroke risk management in non-valvular atrial fibrillation.
  • Optimizing anticoagulation adherence is essential for reducing cardiovascular mortality and preventing disabling strokes in patients with hypertension and atrial fibrillation.

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