Targeting the renin–angiotensin–aldosterone system in atrial fibrillation: from pathophysiology to clinical trials

The 2007 revised ESC/ESH Guidelines in the management of hypertension: clarifying individual patient care

“…However, the nature of this interesting linkage requires further study as most evidence has failed to compare the inclusion of an equivalent blood pressure-lowering strategy, and certainly a similar impact appears to be prevalent with ACEI use. 16 The guideline states clearly that ACEI or ARB should never be used in pregnancy, yet the absolute risk of teratogenicity when exposed in the first trimester is low (often the co-administration being noted at the time of pregnancy confirmation). It may be important to stress that the inadvertent use of an ACEI or ARB alone, while an indication for cessation of treatment is not an acceptable reason to justify abortion in an affected pregnancy.…”

Barriers to Anticoagulation in Patients With Atrial Fibrillation

“…Finally, the risk profile should be reviewed regularly, including detection and optimal management of common risk factors, such as hypertension. 28,29 These factors together with the advent of 'new' oral anticoagulants will hopefully help to improve the prescription of, and compliance with, OAC among eligible AF patients and reduce stroke rates and the associated morbidity and mortality.…”

Blood pressure measurement in atrial fibrillation: goodbye mercury?

“…This point being particularly pertinent in that AF is the commonest chronic sustained cardiac arrhythmia, for which hypertension in a common aetiological factor. 16 Furthermore, hypertension is a major contributor to the risk of stroke and thromboembolism associated with this arrhythmia, and the presence of AF is one indication for antithrombotic therapy use in hypertension. 17 In a recent issue of the Journal of Human Hypertension, Jani et al 18 compared the accuracy of blood pressure readings using the manual mercury sphygmomanometer and Omron HEM -750 CP oscillometric device, in patients with AF and subjects with SR. Their results suggest that the Omron HEM -750 CP can be used in patients with AF, but stress the importance of multiple readings when using the mercury sphygmomanometer in the clinic settings.…”