Key result
Hypertension combined with paroxysmal atrial fibrillation was associated with a 9.31% reduction in plasma NO2 levels compared to hypertension alone, alongside an inverse correlation with aldosterone.
Why the study?
Hypertension and paroxysmal atrial fibrillation frequently coexist, suggesting shared pathophysiological mechanisms whose understanding is important for diagnostic and therapeutic strategies.
Observational (n=169)
Open-label
Yes
Effect estimate: 9.31% reduction
Absolute Event Rate: 6.14% vs 6.77%
p-value: p=0.01
Patients with hypertension and paroxysmal atrial fibrillation exhibit a significant inverse relationship between RAAS activity (aldosterone) and endothelial dysfunction markers (nitric oxide metabolites), suggesting a shared pathophysiological mechanism.
Hypothesis-generating for shared mechanisms in hypertension and paroxysmal AF; prospective studies needed before clinical adoption.
Introduction. Hypertension and paroxysmal atrial fibrillation are among the most prevalent cardiovascular conditions, with their incidence steadily increasing with age. The comorbidity of these two diseases is commonly observed in clinical practice, suggesting the presence of shared pathophysiological mechanisms and interconnected risk factors. Understanding these interrelations is important for improving diagnostic and therapeutic strategies. Objectives: To investigate potential associations between indicators of the renin– angiotensin–aldosterone system (RAAS) and markers of endothelial dysfunction in patients diagnosed with hypertension in combination with paroxysmal atrial fibrillation. Materials and Methods. This study is based on a comprehensive examination and dynamic observation of 136 patients with hypertensive disease. Among them, 100 patients had hypertension combined with paroxysmal atrial fibrillation, while 36 patients had hypertension without atrial fibrillation. Additionally, a control group of 33 clinically healthy volunteers was examined on an outpatient basis at the Regional Medical and Physical Culture Dispensary, Zaporizhzhia. All participants provided written informed consent by signing the Informed Consent Form for Participation in the Study. Results. In patients with hypertension and paroxysmal atrial fibrillation, the aldosterone level was 172.42 (142.06; 193.15) pg/ml, significantly higher than in both the hypertensive patients without atrial fibrillation and the healthy control group (p < 0.05). The level of NO₂ (nitrite) was found to be lowest in the group with combined hypertension and atrial fibrillation, measured at 6.14 (5.62; 6.66) µmol/l. This represents a 9.31% reduction compared to hypertensive patients without atrial fibrillation and a 22.47% reduction compared to the control group (p < 0.05). These findings confirm a significant inverse correlation between aldosterone and NO₂ levels (R = -0.26, p = 0.01). Additional statistically significant correlations were also identified between other components of the RAAS and nitric oxide metabolites. Conclusion. A significant inverse relationship was observed between RAAS activity and nitric oxide metabolites in patients with hypertension combined with paroxysmal atrial fibrillation. This may play a crucial role in the pathogenesis, progression, and recurrence of atrial fibrillation, highlighting the importance of endothelial function and RAAS modulation in disease management.
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Lytvynenko et al. (2025) conducted an observational in Hypertension and paroxysmal atrial fibrillation (n=169). Hypertension combined with paroxysmal atrial fibrillation vs. Hypertension without atrial fibrillation was evaluated on Plasma NO2 (nitrite) concentration (9.31% reduction, p=0.01). Hypertension combined with paroxysmal atrial fibrillation was associated with a 9.31% reduction in plasma NO2 levels compared to hypertension alone, alongside an inverse correlation with aldosterone.
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