Atrial fibrillation (AF) and arterial hypertension (AH) are highly prevalent conditions that often coexist together. Even they are both responsible for high morbidity and mortality, adequate AH control is only marginally followed. Adequate antihypertensive treatment is a paramount to protect patients from devastating consequences of structural heart disease (LV hypertrophy, LV dilatation and impaired LV function) that increases risk of thromboembolic complications. At the same time uncontrolled high blood pressure (BP) increases the risk of stroke and bleeding events (ie intracranial bleeding) and furthermore may lead to recurrent AF.
All 1975 consecutive patients with non-valvular (NV) AF that visited 150 out-patient clinics were enrolled to nationwide prospective cross-sectional registry.
AH was the most frequent comorbidity in the registry that was observed in 1756 (88.9%) pts. Coronary artery disease was disproportionally frequent, documented in 833 (42.2%) pts; 329 (16.7%) pts suffered from previous stroke/transient ischemic attack, heart failure was presented in 587 (29.7%) pts. Target BP levels according to ESC guidelines were achieved in 91% pts. (mean SBP 133.6 ± 15.1mmHg; DBP 79.5 ± 9.5 mmHg). Those with inadequate BP control had mean SBP 157.9 ± 21.8 and DBP 89.5 ± 12.6 mmHg. AH control in this selected population with NVAF was much better that in other nationwide registries of patients with other cardiovascular conditions that were done previously. The results of BP measurements in the SLOV-FIB registry dispute the truth of essential impact of BP control for development of stroke/TIA in observed pts. Better BP control could be explained by better adherence of pts with AF to antihypertensive treatment. Nevertheless, the fact that pts were managed dominantly by specialists in internal medicine and cardiology may also play role in better BP control.
More attention should be paid to rigorous blood pressure control in AF pts. It is an integral part of their management both in primary as well in secondary prevention of AF and its complications.
1National Cardiovascular Intsitute, Bratislava, Slovak Republic
2DSC Services, Brno, Czech Republic