ReviewsHypertension and atrial fibrillation diagnostic approach, prevention and treatment. Position paper of the Working Group ‘Hypertension Arrhythmias and Thrombosis’ of the European Society of HypertensionManolis, Athanasios J.a; Rosei, Enrico Agabitib; Coca, Antonioc; Cifkova, Renatad; Erdine, Serap E.e; Kjeldsen, Sverref; Lip, Gregory Y.H.g; Narkiewicz, Krzysztofh; Parati, Gianfrancoi; Redon, Josepj; Schmieder, Rolandk; Tsioufis, Costasl; Mancia, GiuseppemAuthor Information aDepartment of Cardiology, Asklepeion General Hospital, Athens, Greece bDepartment of Medical and Surgical Sciences, Clinic of Internal Medicine, University of Brescia, Brescia, Italy cHypertension Unit, Department of Internal Medicine, Hospital Clinic, University of Barcelona, Barcelona, Spain dDepartment of Preventive Cardiology, Institute of Clinical and Experimental Medicine, Prague, Czech Republic eSchool of Medicine, Istanbul University Cerrhpa, Istanbul, Turkey fDepartment of Cardiology, Ullevaal University Hospital, Oslo, Norway gHaemostasis Thrombosis and Vascular Biology Unit, University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK hDepartment of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland iDepartment of Clinical Medicine and Prevention, University of Milano-Bicocca; Centro Interuniversitario di Fisiologia Clinica e Ipertensione & Department Cardiology, S Luca Hospital, Istituto Auxologico Italiano, Milan, Italy jINCLIVA Internal Medicine Hospital Clinico, University of Valencia, Valencia, Spain kMedizinische Klinik, University Erlangen-Nuernberg, Erlangen, Germany l1st Department of Cardiology, Hippokration Hospital, University of Athens, Athens, Greece mClinica Medica, University of Milano-Bicocca, Ospedale San Gerardo, Milan, Italy Correspondence to Athanasios J. Manolis, Department of Cardiology, Asklepeion General Hospital, 1 V. Pavlou str., Athens 16672, Greece. Tel: +302108923630; fax: +302108923209; e-mail: [email protected] Abbreviations: ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; b.i.d., bis in die (twice a day); CCB, calcium channel blockers; ESC, European Society of Cardiology; ESH, European Society of Hypertension; FDA, Federal Drug Association; hs-CRP, highly sensitive C-reactive protein; INR, international normalized ratio; LVH, left ventricular hypertrophy; RAS, renin–angiotensin system; VKA, vitamin K antagonist Received 29 June, 2011 Revised 8 November, 2011 Accepted 8 November, 2011 Journal of Hypertension: February 2012 - Volume 30 - Issue 2 - p 239-252 doi: 10.1097/HJH.0b013e32834f03bf Buy Metrics Abstract Hypertension is the most common cardiovascular disorder and atrial fibrillation is the most common clinically significant arrhythmia. Both these conditions frequently coexist and their prevalence increases rapidly with aging. There are different risk factors and clinical conditions predisposing to the development of atrial fibrillation, but due its high prevalence, hypertension is still the main risk factor for the development of atrial fibrillation. Several pathophysiologic mechanisms (such as structural changes, neurohormonal activation, fibrosis, atherosclerosis, etc.) have been advocated to explain the onset of atrial fibrillation. The presence of atrial fibrillation per se increases the risk of stroke but its coexistence with high blood pressure leads to an abrupt increase of cardiovascular complications. Different risk models are available for the risk stratification and the prevention of thromboembolism in patients with atrial fibrillation. In all of them hypertension is present and is an important risk factor. Antihypertensive treatment may contribute to reduce this risk, and it seems some classes are superior to others in the prevention of new-onset atrial fibrillation and prevention of stroke. Antithrombotic treatment with warfarin is effective in the prevention of thromboembolic events, although quite recently, new classes of anticoagulants that do not require international normalized ratio monitoring have been introduced with promising results. © 2012 Lippincott Williams & Wilkins, Inc.