Atrial Fibrillation (AF) Associated with Arterial Hypertension in the Cardiology Department of the Gabriel Touré University Hospital Center (CHU-GT), Mali

Introduction: Hypertension and atrial fibrillation are both very common and closely intertwined. There is limited data on this association in our setting, which motivated the present study. Objective: The aim of this study was to investigate the epidemiological and clinical aspects of atrial fibrillation associated with arterial hypertension in a hospital setting. Methods: This was a cross-sectional and descriptive study conducted with retrospective recruitment in the cardiology department of the Gabriel Touré University Hospital Center over a period from January 2015 to December 2018, spanning four years. It involved the analysis of records of patients hospitalized in the department. Results: During the study period, 52 patients were diagnosed with atrial fibrillation, of which 34 were hypertensive, yielding a proportion of AF associated with hypertension of 65.40%. Atrial fibrillation accounted for 4.39% of hospital admissions. The mean age of the patients was 66 years, with a standard deviation of 12 years, ranging from 30 to 87 years. The sample consisted of 25 women (74%) and 9 men (26%). More than half of the patients (58.82%) presented with elevated blood pressure at the time of admission. Heart failure (44.11%) with clinical signs of decompensation was the predominant finding at the time of discovery. Atrial fibrillation was associated with left ventricular hypertrophy in 14.71% of cases as seen in electrocardiograms. Among the 20 patients with elevated blood pressure, 85% had received antihypertensive therapy (monotherapy 82.35%). Forty-seven percent (47%) of patients had received slowing treatment with digoxin (41%) and beta blockers (18%). Only 44% of patients at high risk of thromboembolism were receiving oral anticoagulant therapy with a vitamin K antagonist. Conclusion: The association between atrial fibrillation and arterial hypertension is prevalent in our practice, particularly among women and the elderly. The clinical presentation was characterized by cardiac decompensation and elevated blood pressure. The majority of patients with poorly controlled hypertension were on antihypertensive monotherapy. Renin-angiotensin system blockers were the most commonly prescribed. Anticoagulant and anticoagulant therapy was initiated in less than half of our sample, despite the high risk of thromboembolism and high mean heart rate.