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Europace. 2017 Jun 1;19(6):891-911. doi: 10.1093/europace/eux091.

Hypertension and cardiac arrhythmias: a consensus document from the European Heart Rhythm Association (EHRA) and ESC Council on Hypertension, endorsed by the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS) and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE).

Author information

1
Institute of Cardiovascular Sciences, University of Birmingham, UK.
2
Aalborg Thrombosis Research Unit, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
3
Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clínic (IDIBAPS), University of Barcelona, Barcelona, Spain.
4
Karolinska Institutet Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden.
5
Department of Cardiology, Danderyd University Hospital Corp, Stockholm, Sweden.
6
Cardiology Department, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy.
7
Third Department of Cardiology, Athens University School of Medicine, Athens, Greece.
8
Department of Internal Medicine, Holbaek Hospital and Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, University of Southern Denmark, Denmark.
9
Department of Cardiology, Memorial Ankara Hospital, Heart and Health Foundation of Turkey, Ankara, Turkey.
10
School of Medicine, Cardiology Clinic, Clinical Centre of Serbia, Belgrade University, Belgrade, Serbia.
11
Electrophysiology and Cardiac Devices, Department of Cardiology, University Heart Center Zurich; Zurich, Switzerland.
12
Department of Cardiology, Hospital Universitario Virgen de la Arrixaca, IMIB-Arrixaca, University of Murcia, Murcia, Spain.
13
Cardiology Department, Medicine School, State University of Campinas, Sao Paulo, Brazil.
14
Department of Translational Medical Sciences, Federico II University Hospital, via S. Pansini 5, bld # 1, Napoli 80131, Italy.
15
Cardiac Electrophysiology, Division of Cardiology, University of Colorado School of Medicine, Aurora, CO, USA.
16
Division of Cardiology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan.
17
Institute of Cardiovascular Science, University College London, UK.
18
Colentina University Hospital, Medicine Faculty, University of Medicine "Carol Davila"-Bucharest Romania.
19
Eskisehir Osmangazi University, Eskisehir, Turkey.
20
Centre Hospitalier Universitaire Trousseau, Tours, France.
21
St George's University Of London, London, UK.
22
National Cardiovascular Institute, NUSCH, Bratislava, Slovak Republic.
23
University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
24
University Medical Centre, Hypertension Department, Hospital Dr. Peter Drzaja, Ljubljana, Slovenia.
25
Istanbul University Cerrahpasa Medical School, Head of Hypertension Department, Istanbul, Turkey.
26
Clinic for internal disease Intermedica, Cardiology department-Hypertension centere, Serbia.
27
Korea University Medical Center, Seoul, Korea.
28
Clínica Delgado, Miraflores, Pérou.
29
University of Wisconsin, Clinical Science Center, Madison, USA.

Abstract

Hypertension is a common cardiovascular risk factor leading to heart failure (HF), coronary artery disease, stroke, peripheral artery disease and chronic renal insufficiency. Hypertensive heart disease can manifest as many cardiac arrhythmias, most commonly being atrial fibrillation (AF). Both supraventricular and ventricular arrhythmias may occur in hypertensive patients, especially in those with left ventricular hypertrophy (LVH) or HF. Also, some of the antihypertensive drugs commonly used to reduce blood pressure, such as thiazide diuretics, may result in electrolyte abnormalities (e.g. hypokalaemia, hypomagnesemia), further contributing to arrhythmias, whereas effective control of blood pressure may prevent the development of the arrhythmias such as AF. In recognizing this close relationship between hypertension and arrhythmias, the European Heart Rhythm Association (EHRA) and the European Society of Cardiology (ESC) Council on Hypertension convened a Task Force, with representation from the Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE), with the remit to comprehensively review the available evidence to publish a joint consensus document on hypertension and cardiac arrhythmias, and to provide up-to-date consensus recommendations for use in clinical practice. The ultimate judgment regarding care of a particular patient must be made by the healthcare provider and the patient in light of all of the circumstances presented by that patient.

KEYWORDS:

Arrhythmias; Atrial fibrillation; EHRA consensus document; Hypertension; Left ventricular hypertrophy

PMID:
28881872
DOI:
10.1093/europace/eux091
[Indexed for MEDLINE]

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