Hypertension and atrial fibrillation: Why controlling your blood pressure could save your heart

Hypertension is often called the “silent killer” because it can present with no symptoms. However, if left untreated, it can lead to serious cardiovascular health problems due to the increased stress it places on the arteries and heart tissue. These health problems include heart attacks, heart failure, stroke, and enlargement of the aorta, all of which can be fatal.An often overlooked but equally consequential cardiovascular complication it can cause is atrial fibrillation (AF), the most common abnormal heart rhythm.
During AF, the heart’s upper chambers (atria) beat hundreds of times per minute in a chaotic and irregular fashion. For many people, this may not elicit any symptoms, while for others it can cause severe symptoms, including a pounding heartbeat, shortness of breath, light-headedness, or profound fatigue. Regardless of how the symptoms manifest, AF is a serious condition that increases the mortality risk for affected individuals and can lead to life-threatening strokes if left untreated. The worldwide prevalence of atrial fibrillation exceeds 60 million individuals, but this is likely an underestimate, considering that many people can intermittently experience AF without symptoms.
High blood pressure, also known as hypertension, occurs when blood flows through blood vessels (arteries) at a higher-than-normal pressure. Blood pressure is measured with two numbers: the top number is the pressure in your blood vessels when your heart beats (systolic pressure), and the bottom number measures the force of blood in your arteries while your heart is relaxed (diastolic pressure). A systolic pressure above 130 or a diastolic pressure above 80 is consistent with hypertension.
Hypertension is present in 60% to 80% of people with AF and is estimated to be directly responsible for over 20% of new AF cases. Therefore, hypertension is one of the strongest risk factors leading to the development of AF. Chronically elevated blood pressure induces many changes in the tissue of the upper chambers of the heart, such as altering electrical properties, increasing inflammation, and accelerating scar formation, all of which heighten the likelihood of developing AF.
Fortunately, studies have clearly shown that good blood pressure control (The impact of lifestyle modifications on reducing blood pressure, and consequently the risk for AF, cannot be overstated. Although these modifications require a certain level of intention, determination, and hard work, the benefits are both obvious and overwhelming. Various measures can help improve blood pressure, including achieving a healthy body weight, eating a heart-healthy diet (rich in fruits, vegetables, whole grains, and low-fat dairy products, but low in saturated and saturated). total fat), reducing dietary sodium, increasing dietary potassium to as much as 5 grams per day, engaging in at least 150 minutes of aerobic activity per week, and moderating alcohol intake for those who consume more than one to two drinks per day Adopting. any one of these behaviors can reduce blood pressure by an average of 4 to 5 points on the systolic reading and 2 to 3 points on the diastolic reading. The improvements in blood pressure multiply as more of these behaviors are adopted.
Of course, the first and most important step is to get your blood pressure checked. Otherwise, the presence of hypertension remains “silent,” meaning it is unknown and untreated. This “silent killer” often makes its presence known only when severe cardiovascular consequences arise—oftentimes, too late. Knowing your blood pressure numbers, engaging in heart-healthy behaviors, and starting drug treatment if appropriate are the best ways to prevent this “silent killer” from remaining silent until it is potentially too late.
(Author: Parveen K. Garg, MD, Associate Professor at Keck School of Medicine of USC)