Alodhayani Abdulaziz A, Alkhushail Abdullah, Alhantoushi Mashhor, Alsaad Saad M, Almigbal Turky H, Alotaibi Khalid, Batais Mohammed A, Altheaby Abdulrahman, Al Dalbhi Sultan, Alghamdi Yasser
Department of Community and Family Medicine, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia.
Prince Sultan Cardiac Center, Riyadh, Saudi Arabia.
Int J Health Sci (Qassim). 2019 Nov-Dec;13(6):39-46.
Uncontrolled hypertension is a main predisposing risk factor leading to chronic atrial fibrillation (AF). Although several treatment methods for patients with HTN and AF were developed in past decades, further investigations of their efficacies are needed. This systematic narrative review presents an overview of studies reporting treatment efficacies in patients with HTN and/or AF.
A narrative-based systematic review was performed using EMBASE, Medline, PubMed, Google Scholar, and the Cochrane Library searching for relevant papers published between October 2008 and October 2018. Out of 4481 studies, only 15 studies could be included following the inclusion criteria.
Included studies reported treatment measures, measured outcomes, and efficacies in adult patients with HTN and AF with defined interventions and methodologies. Treatment methods with effective outcomes were administration of hydrochlorothiazide, losartan or atenolol, telmisartan or amlodipine, or general anti-hypertensive drugs. Treatment methods that showed the most effective outcomes (lowering AF recurrence and improving BP control) were those containing pulmonary vein (or antrum) isolation (PVI/PVAI) (6 studies) and/or in conjunction with renal denervation (RDN)(6 studies). Treatment methods showing the most effective outcomes were PVI/PVAI in conjunction with RDN.
The latest evidence shows that PVI (in conjunction with RDN in some instances) was more efficacious among patients suffering from HTN and/or AF.
未控制的高血压是导致慢性心房颤动（AF）的主要诱发危险因素。尽管在过去几十年中针对高血压合并房颤患者开发了几种治疗方法，但仍需要对其疗效进行进一步研究。本系统叙述性综述概述了报告高血压和/或房颤患者治疗疗效的研究。
使用EMBASE、Medline、PubMed、谷歌学术和Cochrane图书馆进行基于叙述的系统综述，以搜索2008年10月至2018年10月期间发表的相关论文。在4481项研究中，根据纳入标准仅纳入了15项研究。
纳入的研究报告了成人高血压合并房颤患者的治疗措施、测量结果和疗效，采用了明确的干预措施和方法。具有有效结果的治疗方法包括给予氢氯噻嗪、氯沙坦或阿替洛尔、替米沙坦或氨氯地平，或一般抗高血压药物。显示出最有效结果（降低房颤复发率和改善血压控制）的治疗方法是那些包含肺静脉（或前庭）隔离（PVI/PVAI）的方法（6项研究）和/或与肾去神经支配（RDN）联合使用的方法（6项研究）。显示出最有效结果的治疗方法是PVI/PVAI与RDN联合使用。
最新证据表明，PVI（在某些情况下与RDN联合使用）在高血压和/或房颤患者中更有效。
