高血圧と心房細動:AF-SCREEN国際協力によるフロンティアレビュー
Teemu J Niiranen1,2,3, Renate B Schnabel4,5, Aletta E Schutte6,7
1Department of Internal Medicine, University of Turku, Turku, Finland (T.J.N.).
Circulation
|March 24, 2025
まとめ
高血圧は心房細動 (AF) のリスクを大幅に増加させる. 高血圧の同時スクリーニングと治療は AFおよび関連する心血管疾患を予防できますが,さらなる研究が必要です.
科学分野:
- 心臓病科
- 高血圧 研究
- 動脈動に関する研究
背景:
- 高血圧は,心房細動 (AF) の主要な可変リスク因子であり,AF患者の70%以上に影響します.
- 高血圧とAFはしばしば診断されず 治療が不十分であり,脳卒中,心不全,認知症,死亡率のリスクを大幅に高めます
研究 の 目的:
- 高血圧,AF,心血管疾患との関連に関する証拠をレビューする.
- 高血圧とAFの同時スクリーニングを検討する.
- 抗高血圧療法によるAF予防を評価する.
主な方法:
- AF-SCREEN国際コラボレーションの29人の専門家によるレビュー
- 既存の証拠の統合と知識のギャップの特定
- 高血圧とAFを同時に検出するための自動血圧装置の分析
主要な成果:
- 高血圧とAFは密接に関連しており,併せて重大な心血管疾患と死亡率のリスクを高めます.
- 自動血圧装置は高血圧とAFの同時スクリーニングの可能性を示し,AFのEKGの確認が必要です.
- 抗高血圧治療は,特に左心房機能不全の患者では,AFのリスクを低減するのに有効です.
結論:
- 高血圧はAFの予測と予防の主要なターゲットであって,併発症だけではない.
- 高リスクの患者 (≥65歳,治療抵抗性高血圧) は,AFスクリーニングの恩恵を受けることができます.
- 最適なスクリーニング方法,患者の選択,抗高血圧薬のクラス,およびAF予防のための血圧ターゲットに関するさらなる研究が必要です.
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