Frequency of Atrial Fibrillation in Hypertensive Patients
Abstract views: 144
/ 
PDF downloads: 72
DOI:
https://doi.org/10.5281/zenodo.8233496Keywords:
Hypertension, Atrial Fibrillation, Vitamin DAbstract
Hypertension is an important health problem worldwide that can lead to atrial fibrillation (AF) and stroke. Epidemiological studies have shown that hypertension is one of the most common causes of AF. AF, whether symptomatic or asymptomatic, is a risk factor that significantly increases the risk of stroke or systemic thromboembolism. The aim of our study is to investigate the frequency of AF in hypertensive patients.
In our study, the frequency of AF was investigated in 80 adult patients receiving antihypertensive treatment between December 2020 and June 2023. Intermittent standard 12-lead electrocardiograms (ECG) were taken for the diagnosis and investigation of AF. In addition to routine laboratory and radiological examinations of the patients, 25-hydroxyvitamin D (25(OH)D), vitamin B12, magnesium and folate levels were also measured. Our results were expressed as mean ± standard deviation (SD). The t test was used for statistical analysis and a p value less than 0.05 was considered statistically significant.
There were 40 (50%) female and 40 (50%) male patients, ranging in age from 45 to 84 years with a mean age of 65.2±7.9 years. AF was detected in a total of 20 (25%) patients, 10 men and 10 women. The mean age of the patients with AF was 66.5±7.7 years. The mean age was significantly higher in the patients with AF (p<0.05). The mean vitamin D level was significantly lower in hypertensives with AF compared to those with sinus rhythm (p<0.05).
The rate of AF is high in hypertensive patients. Controlling hypertension is essential for rhythm control, heart failure, and prevention of AF and stroke In addition, both hypertension and AF predispose to each other. Since our study showed that vitamin D deficiency is more common in hypertensive patients with AF, we recommend that vitamin D levels should be checked in hypertensive patients.
References
Angeli F, Reboldi G, Trapasso M, et al. European and US guidelines for arterial hypertension: similarities and differences. Eur J Intern Med. 2019;63:3‐8.
Varvarousis D, Kallistratos M, Poulimenos L, Triantafyllis A, Tsinivizov P, Giannakopoulos A, et al Cardiac arrhythmias in arterial hypertension. J Clin Hypertens (Greenwich). 2020;22(8):1371-1378. doi: 10.1111/jch.13989.
Kırali K. Atriyal Fibrilasyonun Tanımlanması.Turkiye Klinikleri J Cardiovasc Surg-Special Topics 2008, 1,4-6.
Fuster V, Ryden LE, Cannom DS, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines fort he management of Patients With Atrial Fibrillation). J Am Coll Cardiol. 2006;48(4):854-906.
Dzeshka MS, Shahid F, Shantsila A, Lip GY. Hypertension and atrial fibrillation: an intimate association of epidemiology, pathophysiology, and outcomes. Am J Hypertens. 2017;30:733–755.
Michniewicz E, Mlodawska E, Lopatowska P, Tomaszuk-Kazberuk A, Malyszko J. Patients with atrial fibrillation and coronary artery disease - Double trouble. Adv Med Sci. 2018;63(1):30-35. doi: 10.1016/j.advms.2017.06.005. Epub 2017 Aug 14. PMID: 28818746.
Varvarousis D, Kallistratos M, Poulimenos L, Triantafyllis A, Tsinivizov P, Giannakopoulos A, et al. Cardiac arrhythmias in arterial hypertension. J Clin Hypertens (Greenwich). 2020;22(8):1371-1378. doi: 10.1111/jch.13989.
Verdecchia P, Angeli F, Reboldi G. Hypertension and atrial fibrillation: doubts and certainties from basic and clinical studies. Circ Res. 2018;122:352–368.
Hirsh BJ, Copeland‐Halperin RS, Halperin JL. Fibrotic atrial cardiomyopathy, atrial fibrillation, and thromboembolism: mechanistic links and clinical inferences. J Am Coll Cardiol. 2015;65:2239‐2251.
Dzeshka MS, Shahid F, Shantsila A, Lip GYH. Hypertension and atrial fibrillation: an intimate association of epidemiology, pathophysiology, and outcomes. Am J Hypertens. 2017;30:733–755.
Barrios V, Escobar C, Prieto Valiente L, Lobos JM, Vargas-Ortega D, Polo J, et al. Blood pressure control in anticoagulated patients with hypertension and atrial fibrillation. Blood Press. 2017 Oct;26(5):279-283. doi: 10.1080/08037051.2017.1313094. Epub 2017 Apr 7. PMID: 28385080.
Rahman F, Yin X, Larson MG, Ellinor PT, Lubitz SA, Vasan RS, et al. Trajectories of risk factors and risk of new-onset atrial fibrillation in the Framingham Heart Study. Hypertension. 2016;68:597–605. doi: 10.1161/HYPERTENSIONAHA.116.07683.
Dzeshka MS, Shantsila A, Shantsila E, Lip GYH. Atrial fibrillation and hypertension. Hypertension. 2017;70:854–861.
Mikhail S. Dzeshka, Alena Shantsila, Eduard Shantsila, Gregory Y.H. Lip.Atrial Fibrillation and Hypertension.Hypertension. 2017;70:854-861. DOI: 10.1161/HYPERTENSIONAHA.117.08934.
Demir M, Uyan U, Melek M. The effects of vitamin D deficiency on atrial fibrillation. Clin Appl Thromb Hemost. 2014;20(1):98-103. doi: 10.1177/1076029612453762.
Kallistratos MS, Poulimenos LE, Manolis AJ. Atrial fibrillation and arterial hypertension. Pharmacol Res. 2018;128:322-6.
Bosch NA, Cimini J, Walkey AJ. Atrial Fibrillation in the ICU. Chest. 2018;154(6):1424-1434. doi: 10.1016/j.chest.2018.03.040. Epub 2018 Apr 6. PMID: 29627355; PMCID: PMC6335260.
Kalogeropoulos A, Tsiodras S, Rigopoulos A, et al. Novel association patterns of cardiac remodeling markers in patients with essential hypertension and atrial fibrillation. BMC Cardiovasc Disord. 2011;11:77.
Manolis AJ, Kallistratos MS, Poulimenos LE. Recent clinical trials in atrial fibrillation in hypertensive patients. Curr Hypertens Rep. 2012;14(4):350-9. doi: 10.1007/s11906-012-0268-5. PMID: 22576674.
Mitchell GF. Arterial stiffness and hypertension. Hypertension. 2014;64:13–18. doi: 10.1161/HYPERTENSIONAHA.114.00921.
Mugnai G, Arcaro G, Vassanelli C. Echocardiographically derived pulse wave velocity and diastolic dysfunction are associated with an increased incidence of atrial fibrillation in patients with systolic heart failure. Echocardiography. 2016;33:1024–1031.
Patel N, O’Neal WT, Whalen SP, Soliman EZ. Electrocardiographic left ventricular hypertrophy predicts atrial fibrillation independent of left ventricular mass. Ann Noninvasive Electrocardiol. 2017;22:1–5. doi: 10.1111/anec.12419.
Nagarakanti R, Wallentin L, Noack H, et al. Comparison of characteristics and outcomes of Dabigatran versus Warfarin in hypertensive patients with atrial fibrillation (from the RE-LY Trial). Am J Cardiol. 2015;116:1204–1209.
Gepner AD, Tedla Y, Colangelo LA, Tattersall MC, Korcarz CE, Kaufman JD, Liu K, Burke GL, Shea S, Greenland P, Stein JH. Progression of carotid arterial stiffness with treatment of hypertension over 10 years: the Multi-Ethnic Study of Atherosclerosis. Hypertension. 2017;69:87–95.
Go O, Rosendorff C. Hypertension and atrial fibrillation. Curr Cardiol Rep. 2009;11(6):430-5. doi: 10.1007/s11886-009-0062-4. PMID: 19863867.
Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the Management of Atrial Fibrillation Developed in Collaboration With EACTS. Eur Heart J. 2016;37(38):2893-2962.
Kallistratos MS, Poulimenos LE, Manolis AJ. Atrial fibrillation and arterial hypertension. Pharmacol Res. 2018;128:322-6.
Yiğit E, Erciyes D. Role of Insulin Resistance in the Development of Atrial Fibrillation.Nam Kem Med J 2022;10(3):265-269.DOI: 10.4274/nkmj.galenos.2022.31932.
Bell DSH, Goncalves E. Atrial fibrillation and type 2 diabetes: Prevalence, etiology, pathophysiology and effect of anti-diabetic therapies. Diabetes Obes Metab. 2019;21:210-7.
Chan YH, Chang GJ, Lai YJ, Chen WJ, Chang SH, Hung LM, et al. Atrial fibrillation and its arrhythmogenesis associated with insulin resistance. Cardiovasc Diabetol. 2019;18:125.
Chang SH, Wu LS, Chiou MJ, Liu JR, Yu KH, Kuo CF, et al. Association of metformin with lower atrial fibrillation risk among patients with type 2 diabetes mellitus: a population-based dynamic cohort and in vitro studies. Cardiovasc Diabetol. 2014;13:123.
Korantzopoulos P, Letsas K, Fragakis N, Tse G, Liu T. Oxidative stress and atrial fibrillation: an update. Free Radic Res. 2018;52(11-12):1199-1209. doi: 10.1080/10715762.2018.1500696.
Kim YM, Kattach H, Ratnatunga C, et al. Association of atrial nicotinamide adenine dinucleotide phosphate oxidase activity with the development of atrial fibrillation after cardiac surgery. J Am Coll Cardiol. 2008;51:68–74.
Sovari AA, Morita N, Karagueuzian HS. Apocynin: a potent NADPH oxidase inhibitor for the management of atrial fibrillation. Redox Rep. 2008;13:242–5.
Costanzo S, De Curtis A, di Niro V, et al. Postoperative atrial fibrillation and total dietary antioxidant capacity in patients undergoing cardiac surgery: The Polyphemus Observational Study. J Thorac Cardiovasc Surg. 2015;149:1175–1182.e1.
Guarracini F, Tritto M, Di Monaco A, Mariani MV, Gasperetti A, Compagnucci P, et al. Stereotactic Arrhythmia Radioablation Treatment of Ventricular Tachycardia: Current Technology and Evolving Indications. J Cardiovasc Dev Dis. 2023 Apr 17;10(4):172.
Emdin CA, Anderson SG, Salimi-Khorshidi G, Woodward M, MacMahon S, Dwyer T, Rahimi K. Usual blood pressure, atrial fibrillation and vascular risk: evidence from 4.3 million adults. Int J Epidemiol. 2017;46:162–172.
Rahman F, Yin X, Larson MG, Ellinor PT, Lubitz SA, Vasan RS, et al. Trajectories of risk factors and risk of new-onset atrial fibrillation in the Framingham Heart Study. Hypertension. 2016;68:597–605. doi: 10.1161/HYPERTENSIONAHA.116.07683.
Lip GY. Atrial fibrillation in patients with hypertension: trajectories of risk factors in yet another manifestation of hypertensive target organ damage. Hypertension. 2016;68:544‐545.
Manolis AJ, Kallistratos M, Poulimenos L. Recent clinical trials in atrial fibrillation in hypertensive patients. Curr Hyperts Rep. 2012;14:350‐359.
Frustaci A, Chimenti C, Bellocci F, Morgante E, Russo MA, Maseri A. Histological substrate of atrial biopsies in patients with lone atrial fibrillation. Circulation. 1997;96(4):1180–1184.
Cerit L, Özcem B, Cerit Z, Duygu H. Preventive Effect of Preoperative Vitamin D Supplementation on Postoperative Atrial Fibrillation. Braz J Cardiovasc Surg. 2018;33(4):347-352. doi: 10.21470/1678-9741-2018-0014.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Euroasia Journal of Mathematics, Engineering, Natural & Medical Sciences
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The journal is licensed under a 