概要
　　高血压相关心律失常与血栓形成
　　高血压是心房颤动（房颤）的重要危险因素，且可能与高血压的流行密切相关。或许高血压患者房颤的风险增加40~50%，但是考虑到整体人群中高血压患者的数量巨大，高血压可能是房颤的主要危险因素。高血压所致的房颤与心脏对高血压的适应有关，如左心室肥厚、舒张性心功能不全和左心室扩大这些情况容易发生房颤。这也是高血压领域的专家关注这一话题的非常重要的原因。控制血压可能预防房颤，且一些药物肯定比另一些药物更有效。很多数据显示降低肾素-血管紧张素系统活性的药物可能预防房颤，特别是对于左心室肥厚的高血压患者。LIFE研究结果印证了该观点。
　　ESH血栓形成和心律失常工作组在本次大会上的重点话题
　　今年大会上，ESH血栓形成和心律失常工作组主要讨论新型抗栓药物的使用及安全性。与传统的抗栓药物如华法令和维生素K拮抗剂相比，新型抗栓药物使用更方便，无需评价患者抗凝活性，且抗栓效果更好，不易被其他药物或食物影响。过去的两年间已有一些临床试验证实了这些新药的获益。另外，工作组也讨论了高血压致房颤的机制以及是否需要更多的研究证实降压药物联合抗血小板药物在减少心血管事件方面的疗效。
　　高血压合并房颤患者卒中预防
　　血压可能是导致卒中发生的最重要因素。目前，大部分人关注新型抗栓药物进展，关注卒中事件的预防，但是往往忽视导致卒中发生的真正原因。高血压正是导致卒中发生的真正原因之一。既往研究数据显示，服用抗凝药物治疗的房颤患者卒中发生率与血压相关。另一个被忽视的事实是，精确测量房颤患者的血压并非易事。在高血压治疗中需要尽可能精确的测量血压，并通过血压评价药物治疗效果。由于血压随着每次心脏搏动而变化，利用新型的电子血压计测量房颤患者血压并不能获得精准的血压值。所以，房颤患者需要多次测量，这种情况却未得到重视。

　　The relationship between arrhythmias and hypertension
　　Hypertension is an important risk factor for atrial fibrillation (AF) and probably the most important， due to its prevalence. Perhaps the risk increases by 40-50% and， considering the very large numbers of hypertensive patients in the general population， it is probably the main risk factor for atrial fibrillation. AF is induced by adaptations of the heart to hypertension. Left ventricular hypertrophy， diastolic dysfunction， and left artery enlargement -- these predispose patients to the onset of atrial fibrillation. This is a very important reason why hypertensive specialists are interested in this topic. We know that reducing blood pressure may prevent atrial fibrillation and certainly some drugs may be more effective than others. We have good data showing that drugs that reduce the activity of the renin-angiotensin system may prevent， somewhat， atrial fibrillation particularly in hypertensive patients with left ventricular hypertrophy. The LIFE study showed this.
　　The biggest topics for the ESH Working Group on Thrombosis and Arrhythmias this past year
　　This year we have been discussing mainly these new antithrombotic drugs that are progressively replacing the old vitamin K antagonists. They are much easier to handle as they don’t require an evaluation of the anticoagulation activity. They are much more stable and are far less influenced by other drugs or food and apparently they are also more effective than warfarin and the vitamin K antagonists. We have had several clinical trials in the last two years that have increased the interest in these new drugs. We have also discussed the mechanism of how hypertension leads to AF and there has also been talk on whether we need more trials demonstrating the efficacy of antiplatelet drugs added to antihypertensive drugs in order to reduce cardiovascular events.
　　The prevention of stroke and blood pressure
　　Blood pressure probably is the most important factor in stroke. This is a topic that has not been evaluated enough. There is a lot of interest in new drugs， but less interest in hypertension， an important player which induces stroke. We have data demonstrating that the incidence of stroke in these patients taking anticoagulants for AF is related to blood pressure. We must be careful of blood pressure in patients with AF. Another important practical observation is that measuring blood pressure in a patient with AF is not easy. The new devices that use an algorithm for determining blood pressure via an electronic device are not measuring levels exactly. You will need several measurements to determine approximately precise blood pressure values because blood pressure changes with every heart beat. This is an obvious practical thing， but it has not been evaluated enough. You have to measure blood pressure as precisely as possible and consider blood pressure in the evaluation of the effect of these drugs.