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Arterial Hypertension, Aldosterone, and Atrial Fibrillation

  • Mechanisms of Hypertension and Target-Organ Damage (JE Hall and ME Hall, Section Editors)
  • Published:
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Abstract

Purpose

Atrial fibrillation is the most common sustained arrhythmia, with a prevalence of 1–2% in the general population and over 15% in people older than 80 years. Due to aging of the population it imposes an increasing burden on the healthcare system because of the need for life-long pharmacological treatment and the associated increased risk of heart failure and hospitalization. Hence, identification of the factors that predispose to atrial fibrillation it is of utmost relevance.

Recent Findings

Several conditions exist that are characterized by inappropriately high levels of aldosterone, mostly primary aldosteronism and the severe or drug-resistant forms of arterial hypertension. In these forms, aldosterone can cause prominent target organ damage, mostly in the heart, vasculature, and kidney.

Summary

This review examines the experimental data and clinical evidences that support a link between hyperaldosteronism and atrial fibrillation, and how this knowledge should lead to a change in our management of the hypertensive patients presenting with atrial fibrillation.

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Funding

The work was supported by grants from the University of Padova (BIRD163255/16; DOR1842303/18; DOR1743424/17; DOR1625891/16) and grant RF2011-02352318 from the Italian Ministry of Health to TMS and GPR.

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Authors and Affiliations

  1. Clinica dell’Ipertensione Arteriosa, Department of Medicine–DIMED, University of Padua, Via Giustiniani, 2, 35128, Padova, Italy

    Teresa M. Seccia, Brasilina Caroccia, Giuseppe Maiolino, Maurizio Cesari & Gian Paolo Rossi

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  1. Teresa M. Seccia
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  2. Brasilina Caroccia
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  3. Giuseppe Maiolino
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  4. Maurizio Cesari
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  5. Gian Paolo Rossi
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Correspondence to Gian Paolo Rossi.

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Seccia, T.M., Caroccia, B., Maiolino, G. et al. Arterial Hypertension, Aldosterone, and Atrial Fibrillation. Curr Hypertens Rep 21, 94 (2019). https://doi.org/10.1007/s11906-019-1001-4

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