| Angiotensin-converting enzyme inhibition in hypertensive patients is associated with a reduction in the occurrence of atrial fibrillation. | |
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MedLine Citation:
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PMID: 15234426 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of this study was to determine the effects of angiotensin-converting enzyme inhibition (ACEI) versus long-acting calcium-channel blockade (CCB) on atrial fibrillation (AF) in patients with hypertension. BACKGROUND: Atrial fibrillation is the most common significant cardiac arrhythmia, and angiotensin II has been implicated in its pathophysiology. METHODS: This was a retrospective, longitudinal cohort study from a database of 8 million people in the U.S. Patients age > or =18 years with hypertension were eligible if they filled a prescription for either an ACEI or a CCB between January 1995 and June 1999. The use of all other antihypertensive medications was permitted. Patient chronic disease burden was assessed using a modified Charlson index. Patients were matched on a propensity score generated from a logistic regression model. A survival analysis approach was used to compare the incidence of AF between groups. The final cohorts were evaluated until June 2002, and the average follow-up was 4.5 years. RESULTS: After cohort matching, 10,926 patients were included in the analysis and divided equally into the ACEI and CCB groups. Mean patient age was 65 years. The adjusted hazards ratio (95% confidence interval [CI]) in the ACEI versus CCB groups for the entire follow-up period was 0.85 (95% CI: 0.74 to 0.97) for new-onset AF, and the adjusted incidence ratio for AF-related hospitalizations was 0.74 (95% CI: 0.62 to 0.89). CONCLUSIONS: Angiotensin-converting enzyme inhibition was associated with a reduced incidence of AF for patients with hypertension in a usual care setting. These results need to be confirmed in a large-scale randomized clinical trial. |
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Authors:
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Philippe L L'Allier; Anique Ducharme; Pierre-Frédéric Keller; Holly Yu; Marie-Claude Guertin; Jean-Claude Tardif |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 44 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2004 Jul |
Date Detail:
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Created Date: 2004-07-05 Completed Date: 2004-09-23 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 159-64 Citation Subset: AIM; IM |
Affiliation:
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Research Center, Montreal Heart Institute, Montreal, Quebec, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Angiotensin-Converting Enzyme Inhibitors / therapeutic use* Antihypertensive Agents / therapeutic use Atrial Fibrillation / drug therapy* Calcium Channel Blockers / therapeutic use Cohort Studies Female Follow-Up Studies Humans Hypertension / drug therapy* Incidence Longitudinal Studies Male Middle Aged Retrospective Studies Risk Reduction Behavior* Statistics as Topic Treatment Outcome United States / epidemiology |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers |
| Comments/Corrections | |
Comment In:
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J Am Coll Cardiol. 2005 Apr 5;45(7):1144; author reply 1144
[PMID:
15808777
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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