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REFLECTIONS
Hypertension
Hypertension Global Newsletter #4 2023

A meta-analysis of 27 randomized clinical trials with 214,763 participants demonstrated that antihypertensive therapy reduced
the risk of AF (predominantly in primary prevention) by 10%. This effect was higher in the heart failure population, where Hypertension
the risk of AF was reduced by 19%. No significant differences in incident or recurrent AF were observed when comparing
antihypertensive drugs against each other.

The authors recommend that the implementation and early initiation of an AF management program should include four key
elements: Patient involvement, multidisciplinary care team, technology tools, and access to all treatment options for AF (ABC
pathway, see below). Patient education should include discussing treatment options, goals, success rates and potential risks,
understanding the long treatment trajectory and learning to live with AF. Multidisciplinary AF management and implementing the
ABC pathway have improved patient care and AF outcomes. Finally, mobile health tools can facilitate further patient support
and monitoring.

The authors conclude with the recommendation that
hypertension treatment should be initiated in patients
identified with AF, as part of a comprehensive risk factor
modification program. In those where AF has not been
detected, hypertension is an important modifiable risk factor
for primary prophylaxis of incident AF.

CLINICAL PEARLS FROM THE FACULTY

WATCH
PROF. VILLEVALDE DISCUSS HER
THOUGHTS ON THE CLINICAL
SIGNIFICANCE OF THIS REVIEW
CLICK HERE IN THE MANAGEMENT OF AF IN
FOR THE LINK TO FULL ARTICLE PATIENTS WITH HYPERTENSION.

ARTICLES OF INTEREST

EPIDEMIOLOGY

1. Measured blood pressure, genetically predicted blood pressure, and cardiovascular disease risk in the UK biobank.
Co SMJ, et al. Hypertension. 2023 Mar;80(3):523-533.

2. Cardiovascular risk factor prevalence, treatment, and control in US adults aged 20 to 44 years, 2009 to March 2020.
Aggarwal R, et al. Hypertension. 2023 Mar;80(3):523-533.
3. The global syndemic of metabolic diseases in the young adult population: A consortium of trends and projections
from the Global Burden of Disease 2000-2019. Chong B, et al. Metabolism. 2023 Apr;141:155402.

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