scholarly journals Atrial fibrillation and hypertension: current understanding of the pathogenesis, diagnosis, and treatment

2019 ◽  
Vol 34 (3) ◽  
pp. 13-20
Author(s):  
M. A. Kirgizova ◽  
R. E. Batalov ◽  
B. A. Tatarsky ◽  
S. V. Popov
Keyword(s):  
Atrial Fibrillation ◽  
Literature Review ◽  
Secondary Prevention ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Optimal Treatment ◽  
Current Understanding ◽  
Diagnosis And Treatment ◽  
Thromboembolic Complications ◽  
Primary And Secondary Prevention

The present literature review is devoted to the analysis of the features of the pathogenesis of atrial fibrillation in patients with arterial hypertension and to the optimal treatment tactics in this cohort of patients. In particular, pathological mechanisms (hemodynamic, structural, and electrophysiological) of the development of atrial fibrillation in arterial hypertension are reviewed. The article highlights the problems of primary and secondary prevention of atrial fibrillation using antihypertensive therapy as well as the aspects of the prevention of thromboembolic complications in patients with atrial fibrillation and arterial hypertension.

scholarly journals Atrial fibrillation: review of the European Society of Cardiology guidelines and national guidelines 2020

2020 ◽  
pp. 21-29
Author(s):  
Natalia S. Mescherina ◽  
Elena M. Khardikova ◽  
Igor A. Saraev
Keyword(s):  
Atrial Fibrillation ◽  
European Society ◽  
Stroke Risk ◽  
Diagnosis And Treatment ◽  
Russian Society ◽  
Thromboembolic Complications ◽  
National Guidelines ◽  
European Society Of Cardiology ◽  
Risk Symptom

The review presents the key provisions of the recommendations of the Russian society of cardiology and the guidelines of the European society of cardiology for the diagnosis and treatment of atrial fibrillation (AF), updated in 2020. The recommendations clearly state the requirements for atrial fibrillation diagnosis verification, and propose an approach to the formation of a complex characteristic of the disease in four positions, which is designated as 4S-AF (Stroke risk, Symptom severity, Severity of AF burden, Substrate severity). The authors analyzed the strategy "CC To ABC" (Confirm AF, Characterize AF, Treat AF: the ABC pathway) proposed by European experts, the issues of modern terminology and requirements for verifying the diagnosis of AF, complex characteristics of the disease and stratification of the risk of stroke and bleeding, a new ABC approach in the treatment of AF, where A is anticoagulant prevention of thromboembolic complications, B is the control of symptoms of the disease and C is the detection and treatment of comorbid pathology. The General principles that have changed in comparison with the previous versions of guidelines of 2016 on the initiation and tactics of anticoagulant therapy, pharmacological and non-drug cardioversion, catheter ablation in patients with AF, affecting the prognosis and outcomes in patients with AF, are outlined. It is emphasized that the pattern of atrial fibrillation (first diagnosed, paroxysmal, persistent, long-term persistent, permanent) should not determine the indications for anticoagulant prevention. The solution to this issue is determined by the level of risk according to the CHA2DS2-VASc scale. The introduction of the considered methods of diagnosis and treatment of AF into clinical practice will optimize the burden on the health care system and reduce the costs associated with the burden of AF.

scholarly journals Problems of Cardioembolic Stroke Primary and Secondary Prevention in the Latvian Population / Kardioemboliska Cerebrāla Infarkta Primārās un Sekundārās Profilakses Problēmas Latvijā

2015 ◽  
Vol 69 (5) ◽  
pp. 199-204
Author(s):  
Kristaps Jurjāns ◽  
Santa Sabeļnikova ◽  
Evija Miglāne ◽  
Baiba Luriņa ◽  
Oskars Kalējs ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Secondary Prevention ◽  
Patient Group ◽  
Oral Anticoagulants ◽  
Antiplatelet Agents ◽  
Cardioembolic Stroke ◽  
University Hospital ◽  
Primary And Secondary Prevention ◽  
Stroke Patients ◽  
Very High

Abstract Atrial fibrillation is one of major risk factors of cerebral infarction. The use of oral anticoagulants is the only evidence-based method of reducing the risk of cardioembolic accidents. The guidelines of oral anticoagulant admission and usage have been available since 2012. The results of this study show that of 550 stroke patients that were admitted to Pauls Stradiņš Clinical University Hospital, Rīga, Latvia, from 1 January 2014 until 1 July 2014, atrial fibrillation was diagnosed in 247 (45%) cases, and of these patients, only 8.5% used oral anticoagulants before the onset of stroke. Six months after discharge of 111 (44.9%) stroke survivors, five (4.5%) used no secondary prevention medication, 27 (24.3%) used antiplatelet agents, 54 (48.6%) warfarin, and 25 (22.5%) used target specific oral anticoagulants (TSOACs). The mortality rate was significantly higher in the patient group that used no secondary prevention medication or antiplatelet agents compared to the patient group that used oral anticoagulants. The use of oral anticoagulants for primary stroke prevention in Latvia is insufficient. The mortality of cardioembolic stroke in 180 days is very high - 40.4%. Secondary prevention is essential to prevent recurrent cardioembolic accidents.

scholarly journals Atrial fibrillation and arterial hypertension

2011 ◽  
Vol 17 (4) ◽  
pp. 293-304
Author(s):  
E. I. Baranova
Keyword(s):  
Atrial Fibrillation ◽  
Arterial Hypertension ◽  
Enzyme Inhibitors ◽  
Anticoagulation Therapy ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Primary And Secondary Prevention ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

Review deals with atrial fibrillation and arterial hypertension. Possible pathological mechanisms of atrial fibrillation due to hypertension include haemodynamic effects, structural and electrophysiological heart remodeling partly connected with activation of renin-angiotensin-aldosterone system. Problems of primary and secondary prevention of atrial fibrillation in hypertensive patients are discussed, particularly the role of antihypertensive treatment including angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. Risk stratification for stroke and thromboembolism and anticoagulation therapy are discussed.

scholarly journals Atrial fibrillation and arterial hypertension

2011 ◽  
Vol 17 (4) ◽  
pp. 293-304 ◽  
Author(s):  
E. I. Baranova
Keyword(s):  
Atrial Fibrillation ◽  
Arterial Hypertension ◽  
Enzyme Inhibitors ◽  
Anticoagulation Therapy ◽  
Angiotensin Converting Enzyme Inhibitors ◽  
Angiotensin Ii Receptor ◽  
Primary And Secondary Prevention ◽  
Converting Enzyme Inhibitors ◽  
Receptor Blockers

Review deals with atrial fibrillation and arterial hypertension. Possible pathological mechanisms of atrial fibrillation due to hypertension include haemodynamic effects, structural and electrophysiological heart remodeling partly connected with activation of renin-angiotensin-aldosterone system. Problems of primary and secondary prevention of atrial fibrillation in hypertensive patients are discussed, particularly the role of antihypertensive treatment including angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. Risk stratification for stroke and thromboembolism and anticoagulation therapy are discussed.

scholarly journals Right Ventricular Dysfunction and Failure in Chronic Pressure Overload

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Marc A. Simon ◽  
Michael R. Pinsky
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Right Ventricular ◽  
Cause Of Death ◽  
Ventricular Dysfunction ◽  
Pressure Overload ◽  
Right Ventricular Dysfunction ◽  
Current Understanding ◽  
Diagnosis And Treatment ◽  
Pulmonary Arterial

Right ventricular (RV) dysfunction is the main cause of death in pulmonary arterial hypertension (PAH). Our understanding of the pathophysiology of RV dysfunction is limited but improving. Methods to better diagnose RV dysfunction earlier and treatments specifically designed to minimize or reverse the remodeling process are likely to improve outcomes. We review the current understanding of RV dysfunction in chronic pressure overload and introduce some novel insights based on recent investigations into pathophysiology, diagnosis, and treatment.

scholarly journals НIGH-RENIN HYPERTENSIONS: FROM SYMPTOM TO dIAGNOSIS

2017 ◽  
Vol 9 (2) ◽  
pp. 7-18
Author(s):  
A V Barsukov ◽  
N N Korneychuk ◽  
S B Shustov
Keyword(s):  
Blood Pressure ◽  
Essential Hypertension ◽  
Arterial Hypertension ◽  
Antihypertensive Therapy ◽  
Diagnostic Value ◽  
Current Understanding ◽  
System Function ◽  
Renin Angiotensin Aldosterone System ◽  
Successful Strategy ◽  
Diagnostic Studies

The article highlights the current understanding of renin-angiotensin-aldosterone system function- ing, as well as mechanisms for blood pressure raising depending on its activity. Authors presented data on the prevalence and characteristics of arterial hypertension with high levels of renin. Along with high-renin essential hypertension authors considered secondary arterial hypertensions accompanied by high-renin status increasing the diagnostic value of this hormone determination and explains the fea- tures of pathophysiological processes occurring in patients’ organism. Authors proved the importance of renin status diagnostic studies allowing defining a successful strategy of antihypertensive therapy.

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