High blood pressure and atrial fibrillation
High blood pressure (hypertension) is one of the most common long-term contributors to atrial fibrillation. It often acts silently for years, changing the heart’s structure and making AF more likely.
Why blood pressure leads to AF
When blood pressure is high, the heart must pump against extra resistance. Over time this can cause:
- Thickening of the heart muscle (the heart works harder).
- Stiffness (the heart relaxes less well between beats).
- Higher filling pressures that push backwards into the left atrium.
- Stretching/enlargement of the atria, which disrupts normal electrical signalling.
Why it can look “normal” now
Many people develop AF even though their blood pressure is “fine today.” The relevant issue is often the history of blood pressure over years. AF can appear after the atria have been under strain for a long time.
Clues that blood pressure may be a contributor
- Long-term hypertension or treatment for hypertension
- Left ventricular thickening (“LVH”) on ECG or echocardiogram
- Enlarged left atrium on echocardiogram
- Shortness of breath on exertion, especially with a “stiff heart” pattern
What usually helps
For many patients, improving blood pressure control is a key part of reducing AF burden. This can include medication, salt reduction, weight changes, treating sleep apnea, and addressing alcohol intake. Your clinician will tailor this.