Hypertension (1) and atrial fibrillation (2,3) both increase with age. Both hypertension and atrial fibrillation are associated with an increased incidence of stroke, heart failure, and mortality (1-3). Hypertension and left ventricular hypertrophy caused by hypertension are major risk factors for atrial fibrillation (1). Hypertension is present in more than 80% of patients with atrial fibrillation (4). At 44-month follow-up of 2,384 older patients, atrial fibrillation was a significant risk factor for new thromboembolic stroke with a risk ratio of 3.2, and left ventricular hypertrophy associated with hypertension was a significant independent risk factor for thromboembolic stroke with a risk ratio of 2.8 (5). At 36-month follow-up of 312 older patients with chronic atrial fibrillation, left ventricular hypertrophy associated with hypertension was a significant independent risk factor for thromboembolic stroke with a risk ratio of 2.8 (6). Hypertension is one of the risk factors for development of thromboembolic stroke in patients with atrial fibrillation in the CHADS2 (7) and CHA2DS2-VASc (8) scoring systems for risk of stroke. Hypertension is present in 74% of patients with congestive heart failure and in 77% of patients with a first stroke (9). Atrial fibrillation was present in 37% of 355 patients, mean age 80 years, with prior myocardial infarction, congestive heart failure, and a reduced left ventricular ejection fraction and in 33% of 296 patients, mean age 82 years, with prior myocardial infarction, congestive heart failure, and a preserved left ventricular ejection fraction (10).
