Improving Outcomes in Patients With Atrial Fibrillation and Hypertension

Atrial fibrillation and hypertension represent 2 of the most important national public health priorities. Atrial fibrillation is the most common sustained cardiac arrhythmia among adults, affecting up to 2% of the US population. The prevalence of atrial fibrillation is expected to increase 3-fold in the next 3 decades. Robust data have identified hypertension as an independent modifiable risk factor for atrial fibrillation and as the most common cardiovascular condition associated with it. Hypertension is present in up to 80% of individuals with atrial fibrillation. Fulfilling a fundamental principle of evidence-based medicine, current therapeutic strategies to maintain sinus rhythm have a firm foundation in appropriately designed clinical trials. Lifestyle modification, treatment with antiarrhythmic and antihypertensive drugs, and pulmonary vein isolation have been established as approaches to relieve the burden of atrial fibrillation and improve outcomes. Despite considerable progress in prevention and treatment, atrial fibrillation continues to impose a significant economic and disability burden in the United States and worldwide. Robust data from clinical trials for the treatment of atrial fibrillation clarifying the risks and benefits of pulmonary vein isolation have resulted in recent expansion of catheter ablation as a guideline-directed approach for select patient populations.
Source: JAMA - Category: General Medicine Source Type: research