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Will hypertension and atrial fibrillation affect each other?

Updated: Jun 1


AFIB is medically called atrial fibrillation. It is mainly caused by the inability of the atria to contract and relax normally, which affects the blood supply of the heart. Generally, patients will have chest pain, fatigue, palpitation, dyspnea and other symptoms at the onset of the disease. If not treated in time, it will cause complications such as pulmonary embolism and heart failure.


AFib is the most common arrhythmia clinically. Adults have a 20% chance of getting sick, and the elderly have a 25% chance. Judging from global heart disease patient case reports, the incidence of AFib is still rising, and there is an increased risk of cardiovascular and cerebrovascular diseases. There are many causes of atrial fibrillation. Hypertension, diabetes, and obesity are all common factors.





The relationship between atrial fibrillation and hypertension


As a relatively stubborn chronic disease, hypertension can easily induce serious cardiovascular diseases. Studies Atrial Fibrillation and Hypertension[1] . have found that 39% of hypertensive patients will have obvious symptoms of arrhythmia at the onset of the disease.


In patients with atrial fibrillation with hypertension, the risk of stroke is increased by 2-3 times. This is because when the patient's blood pressure rises, the blood flow through the heart will undergo dynamic changes, increasing the burden on the left ventricle and left atrium, causing fibrosis of the new chamber, and ultimately leading to changes in the frequency of heartbeats, causing atrial fibrillation.


In addition, hypertension can easily cause atrial fibrillation thromboembolism and bleeding. Therefore, patients with atrial fibrillation receiving anticoagulant therapy need to determine the appropriate blood pressure level to avoid stroke and bleeding.


Although the ACCORD study shows that when the systolic blood pressure is less than 1200mmHg, the incidence of atrial fibrillation can be reduced, but through further analysis, it is found that there is a clear U-shaped curve between the blood pressure level and the incidence of atrial fibrillation patients. Therefore, blindly carrying out antihypertensive treatment is likely to reverse the situation and cause aggravation.


Consequently, in the process of blood pressure control and formulating appropriate blood pressure targets, we must also pay attention to the changes in blood pressure. The greater the fluctuation range, the more serious the damage to the target organs. AFFIRM was measured in the study and found that there is a significant positive correlation between the SBP standard deviation and the risk of adverse events in patients with atrial fibrillation.


Accordingly, patients with atrial fibrillation need to pay attention to the dynamic changes of blood pressure for a long time, set reasonable blood pressure goals, and do a good job in preventing and treating complications such as thromboembolism and cardiac remodeling.


Self-regulation approach for patients with atrial fibrillation


1.Regularly monitor blood pressure and ECG

One-third of atrial fibrillation attacks are asymptomatic. Some patients only detect atrial fibrillation after they have obvious symptoms of stroke and heart failure. Therefore, high-risk groups with multiple complications need regular blood pressure and ECG monitoring.


The Hypertension issued the 2020 ESC Guidelines for the diagnosis and

management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS), the ABC Pathway is proposed in the guide, where C stands for Cardiovascular and Comorbidity optimization, requiring patients with atrial fibrillation to strengthen the management and monitoring of complications such as hypertension.



A study published in Hypertension[2] in 2019 pointed out that the pulse arterial blood pressure variability of patients with atrial fibrillation is large, which will cause the accuracy of blood pressure measurement to become low and the fluctuations are obvious.


Another study published in JOURNAL OF HYPERTENSION[3] in 2020 explored blood pressure measurement in patients with atrial fibrillation by analyzing data from 6 studies and 61,055 patients. Studies have pointed out that there is a big difference between automatic blood pressure measurement and traditional blood pressure measurement. The accuracy of 24h ambulatory blood pressure monitoring for the diagnosis of paroxysmal atrial fibrillation itself is higher, and the sensitivity and specificity are both close to 1.


Therefore, 24h ambulatory blood pressure monitoring also has good accuracy in heart rate monitoring.


Patients with atrial fibrillation may experience palpitation, chest tightness, dizziness and other suspected symptoms from time to time in daily life, but routine examinations often fail to capture the ECG waveform at the time of the onset, which is not conducive to doctors' judgment.




Viatom ECG recorder adopts Holter ECG inspection method, can maintain long-term measurement, also can capture occasional and short burst arrhythmia that is difficult to find in routine inspection, and facilitate the further collection of a large amount of ECG information for qualitative and quantitative analysis, clarify the frequency and risk of atrial fibrillation. Better still, the device itself is wireless without load, which brings great convenience to patients.

Viatom wireless blood pressure monitor

Viatom Armfit+ as an all-in-one ECG and blood pressure machine are more friendly to hypertensive patients. It can monitor the two important indicators of blood pressure and atrial fibrillation with only one machine. The portable design does not need to consider the environment and location, and it also supports the background output of pdf reports. , It is more helpful for doctors to make judgments. Bring the monitoring that could only be carried out in the hospital to the family, and help more people avoid the onset of disease through home monitoring.


2. Strengthen physical exercise


The moderate intensity and regular physical exercise can reduce the prevalence, morbidity and mortality of atrial fibrillation. In the cardiovascular health study, participants who exercised more had a 46% reduction in morbidity than sedentary participants.


Data show that non-permanent atrial fibrillation patients can reduce atrial fibrillation load by 41% after 12 weeks of moderate-intensity intermittent aerobic training, and can increase peak oxygen consumption (VO2 peak) and left ventricular ejection fraction. Therefore, choosing a sport that suits you and insisting on training can help reduce the risk of disease. Most patients with atrial fibrillation are around 45-70 years old. For example, walking and yoga are good exercise methods.


3. Develop good eating habits


Although there is no clear research showing which foods patients with atrial fibrillation cannot eat, following some healthy diet principles and sticking to them for a long time will be of great help to alleviating atrial fibrillation. You can add more protein and vitamin-rich foods to your daily diet, and eat less high-fat and high-cholesterol foods. Minimize the frequency of intake of irritating foods such as coffee, tobacco and alcohol.


4. Regulate emotions


Many people confuse atrial fibrillation with depression because the symptoms of the two appear to be very similar. Anxiety and depression can adversely affect atrial fibrillation by affecting the activity of autonomic nerves, inflammation and endothelial function of the body.


Patients with atrial fibrillation also often experience negative emotions such as tension and depression. Therefore, adjusting the mood is very important for patients with atrial fibrillation. In daily life, you can try to relax emotions and switch attention. Maintaining a good mood and good sleep can reduce the number of attacks at night.


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References


[1]Mikhail S. Dzeshka, Alena Shantsila.Atrial Fibrillation and Hypertension. Hypertension. 2017;70:854–861


[2]Eoin O’Brien,Eamon Dolan.Ambulatory Blood Pressure Measurement in the Elderly: An Opportunity to Screen for Atrial Fibrillation. Hypertension. 2019;73:961–964


[3]Savvari, Paraskevia, et al. Increased detection of suspected atrial fibrillation in elderly and female hypertensive patients through home blood pressure monitoring: the HOME-AF study Journal of Hypertension: March 2020 .doi: 10.1097/HJH.0000000000002291