Antithrombotic treatment in hypertensive patients with chronic atrial fibrillation.: CARDIOTENS 99 study

BACKGROUND: Our main goals were to know the actual degree of oral anticoagulation and antiaggregation in hypertensive patients with atrial fibrillation in the daily clinical practice in Spain and to analyze any differences between primary care physicians and cardiologists. PATIENTS AND METHOD: 32,051 outpatients attended the same day by 1,159 physicians (21% cardiologists) were prospectively included in a database taking into account a history of hypertension and atrial fibrillation, demographic data and ongoing treatments. RESULTS: Hypertension was detected in 10,555 patients and 999 of them had both hypertension and atrial fibrillation (9.46%: 435 males [44%] and 564 females [56%]). 53% patients were attended by primary care physicians and the rest by cardiologists. 33% of hypertensive patients with atrial fibrillation were on oral anticoagulation: 41% of them attended by cardiologists and 26% by primary care physicians (p < 0.05). These differences persisted when the patients were compared on the basis of their age. 39% of hypertensive patients were on oral antiaggregation treatment, without differences in both groups except for those aged less than 65 years who were found to receive more antiaggregation in primary care (36% vs; 24%; p < 0.05). CONCLUSIONS: The prevalence of atrial fibrillation in hypertensive patients is about 10%; there is a suboptimal degree of utilization of oral anticoagulation, which is more evident in patients attended by primary care physicians; elderly patients (> 80 years-old) were found to receive less anticoagulants and more antiaggregants both in primary health-care and cardiology health-care.