Hypertension and Left Ventricular Hypertrophy Is Associated with Atrial Fibrillation in Men

By: Mohan Garikiparithi | Heart Health | Monday, May 21, 2018 - 07:00 AM

Hypertension, or high blood pressure, is a well-documented risk factor for the development of atrial fibrillation and any complications thereof, such as cardiac and cerebrovascular events. What is still yet unknown is whether or not left ventricular hypertrophy (the enlargement and thickening of the walls inside the heart’s main pumping chamber, the left ventricle), which is a symptom of hypertension, also increases the risk of atrial fibrillation.

A new study has emerged that attempted to determine the relationship of left ventricular hypertrophy on atrial fibrillation development in low-risk atrial fibrillation patients and whether there were differences between the sexes.

Participants were found with the Euro Heart Survey and a total of 799 were registered for the study. Follow up lasted one year. Since atrial fibrillation is associated with an increased risk of stroke, and this risk increases over time, participants who demonstrated high risks of stroke were excluded from the selection for this study. Participants were grouped into hypertensive patients and non-hypertensive patients. The hypertensive patients were subdivided into those with left ventricular hypertrophy and those without.

Left Ventricular Hypertrophy Not Related to Atrial Fibrillation in Women

The results showed that 33 percent of the hypertensive participants (379) had left ventricular hypertrophy. In participants without left ventricular hypertrophy, atrial fibrillation developed in 10 percent after one year’s time. In those patients with hypertension and left ventricular hypertrophy, the risk of developing atrial fibrillation increased to 23 percent. This result was only found in male patients, however. In the female participants, there was no related increase of atrial fibrillation development in the presence of left ventricular hypertrophy.

The presence of left ventricular hypertrophy was the most significant factor in determining the progression of a patient’s atrial fibrillation over the course of the year. Even after accounting for other factors, left ventricular hypertrophy remained the most telling symptom as to a participant’s likelihood of the progression of atrial fibrillation.

The researchers found there were no differences in the number of instances of cardiac or cerebrovascular events in either hypertensive participants with or without left ventricular hypertrophy. Overall, the instances of major cardiac or cerebrovascular events were low in both the control and the hypertensive groups, though there were a larger number of these occurrences in the hypertensive group.

From these results, the researchers concluded that the presence of low ventricular hypertrophy in low-risk atrial fibrillation patients with hypertension indicates a greater likelihood that atrial fibrillation will develop within a year’s time. These results were only significant in male patients, however, and this should be taken into consideration for both men and women in the treatment of hypertension associated with left ventricular hypertrophy.

These findings were also restricted to patients with high blood pressure. The control group in the study showed no increase in the likelihood of developing atrial fibrillation, even when left ventricular hypertrophy was present, in these cases excluded from high blood pressure. This signifies that left ventricular hypertrophy on its own is not enough to cause atrial fibrillation, but that some mechanism related to the presence of both hypertension and left ventricular hypertrophy triggers it in many patients.

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Sources:

https://www.ajconline.org/article/S0002-9149(18)31054-3/fulltext?rss=yes

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