Editor-in-Chief: Dimitri P. Mikhailidis Academic Head, Department of Clinical Biochemistry Royal Free Hospital Campus University College London Medical School University College London (UCL) Pond Street London, NW3 2QG UK
Affiliation: 3 Kolokotroni Street, 15236, P. Penteli, Athens, Greece.
Hypertension (HTN) and chronic kidney disease (CKD) often coexist sharing common pathophysiological factors that both in combination and separately induce fibrotic changes in the heart provoking atrial fibrillation (AF). AF, per se, is associated with a 4- to 5-fold increased risk of stroke and a 2-fold increased risk of all-cause death. The co-existence of AF with HTN and renal dysfunction considerably increases morbidity and mortality. Management of AF in hypertensive patients with CKD is complex and multidisciplinary, since these patients have both a prothrombotic state and a coagulopathy with an increased tendency for bleeding. Novel oral anticoagulants such as dabigatran, rivaroxaban and apixaban offer better efficacy and safety especially in patients without optimal treatment with vitamin K antagonists.