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Atrial Fibrillation. Modern Epidemiologic and Therapeutic Aspects

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Special Issues in Hypertension

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Abstract

Atrial Fibrillation (AF) is the most common clinically significant sustained cardiac arrhythmia and hypertension (HTN) is the most common cardiovascular disorder affecting 20–50 % of the adult population in developed countries. The two conditions are interconnected in many aspects. Despite the volume of literature regarding the predictors of AF, it is still difficult to determine an individual’s risk of developing AF. Compared to subjects with normal sinus rhythm, those with AF have a 40–90 % higher risk of overall mortality. AF increases the risk of stroke fourfold to fivefold, is responsible for 15–20 % of all ischemic strokes, and is an independent risk factor for their severity and recurrence. AF has a significant impact on a patient’s quality of life and is associated with all dementia types. In patients with AF and a history of HTN there is a threefold increase in the annual incidence of stroke compared to those with no HTN. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers have been shown to be more effective than other classes of antihypertensive drugs mainly in the primary prevention of AF. Scores such as the CHADS2 and CHA2DS2-VASc scores should be used to determine stroke risk and guide antithrombotic therapy, but hemorrhagic risk also has to be taken into account. Novel classes of anticoagulants that overcome many of the drawbacks of warfarin have been introduced with promising results.

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Authors and Affiliations

  1. Department of Cardiology, Asklepeion General Hospital, Voula, Athens, 16673, Greece

    Leonidas E. Poulimenos, Manolis S. Kallistratos & Athanasios J. Manolis

Authors
  1. Leonidas E. Poulimenos
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  2. Manolis S. Kallistratos
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  3. Athanasios J. Manolis
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Correspondence to Athanasios J. Manolis .

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Editors and Affiliations

  1. , Internal Medicine, American University of Beirut Medical Ce, Riad El Solh, Beirut, 1107-2020, Lebanon

    Adel E. Berbari

  2. Clinica Medica, Ospedale S. Gerardo, Università di Milano-Bicocca, V .Donizetti 106, Milano, Monza, 20133, Italy

    Giuseppe Mancia

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Poulimenos, L.E., Kallistratos, M.S., Manolis, A.J. (2012). Atrial Fibrillation. Modern Epidemiologic and Therapeutic Aspects. In: Berbari, A., Mancia, G. (eds) Special Issues in Hypertension. Springer, Milano. https://doi.org/10.1007/978-88-470-2601-8_32

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  • DOI: https://doi.org/10.1007/978-88-470-2601-8_32

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  • Online ISBN: 978-88-470-2601-8

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