Atrial Fibrillation and Hypertension.

Hypertension has a major impact on the pathogenesis, management, and prognosis of atrial fibrillation (AF; Figure). Common consequences of hypertension, such as left ventricular (LV) hypertrophy, kidney dysfunction, cardiovascular, and cerebrovascular disorders, are recognized risk factors for AF occurrence and development of its complications. Hypertension is very common in AF patients (Figure S1 in the online-only Data Supplement), and evidence points toward a significant contribution of high blood pressure (BP) to AF incidence (Table S1). Patients with hypertension have 1.7-fold higher risk of developing AF than normotensive individuals, and 1 in 6 cases of AF has been attributed to hypertension. Given the high incidence of AF in hypertension, one may even argue that AF is yet another manifestation of the hypertensive target organ damage. Adequate management of hypertension is important for AF prevention, rhythm control, heart failure, and stroke prevention. The management of cardiac arrhythmias in patients with hypertension has been the topic of a recent consensus produced by the European Heart Rhythm Society and European Society of Cardiology Council on Hypertension and endorsed by the Heart Rhythm Society and Asia Pacific Heart Rhythm Society. The objective of this narrative review is to summarize current data on the epidemiology and pathophysiology of hypertension in relation to AF, their management, and ongoing research in the field.