Hypertension and Atrial Fibrillation: Insight From Basic to Translational Science Into the Mechanisms and Management

Abstract

There is a parallel epidemic of atrial fibrillation (AF) and hypertension (HTN) occurring globally. Both AF and HTN are no longer confined to the older population. The pathophysiology of AF related to HTN is complex with many inter-related factors. Hypertension causes hypertrophy of the ventricular musculature, dilatation of atria, elevated intracardiac pressures, atrial and ventricular mechanical dysfunction, abnormal expression of ion channels, dysregulation of the renin-angiotensin-aldosterone system, and the autonomic function. The pathophysiological alterations and structural changes that occur in the atria, including architectural subcellular abnormalities fibrosis, are considered to cause atrial cardiomyopathy (atriopathy) predisposing to AF. In this review, we discuss some relevant and combined basic and translational science data related to HTN leading to atriopathy and AF and possible clinical applications in the treatment and prevention of AF in patients with HTN.

Keywords: atrial cardiomyopathy (atriopathy); atrial fibrillation; atrial fibrosis; hypertension.