Document Detail


Losartan and prevention of atrial fibrillation recurrence in hypertensive patients.
MedLine Citation:
PMID:  16424784     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The aim of the study was to evaluate the effect of losartan as compared with amlodipine, both associated with amiodarone, in preventing the recurrence of atrial fibrillation (AF) in hypertensive patients with a history of recent paroxysmal atrial fibrillation. Two hundred and fifty mild hypertensive (SBP > 140 mm Hg and/or DBP > 90 < 100 mm Hg) outpatients in sinus rhythm but with at least two ECG-documented episodes of symptomatic atrial fibrillation in the previous 6 months and in treatment with amiodarone were randomized to losartan or amlodipine and were followed up for 1 year. Clinic blood pressure (BP) and a 24-hour ECG was evaluated every month; the patients were asked to report any episode of symptomatic atrial fibrillation and to perform an ECG as early as possible. Two hundred and thirteen patients completed the study, 107 in the losartan group and 106 in the amlodipine group. After 12 months the SBP/DBP mean values were significantly reduced by both losartan (from 151.4/95.6 to 135.5/83.7 mm Hg, P < 0.001 versus baseline) and amlodipine (from 152.3/96.5 to 135.2/83.4 mm Hg, P < 0.001 versus baseline), with no difference between the two treatments. At least one ECG-documented episode of atrial fibrillation was reported in 13% of the patients treated with losartan and in 39% of the patients treated with amlodipine. The use of losartan in combination with amiodarone seems more effective than amlodipine/amiodarone combination in preventing new episodes of atrial fibrillation in hypertensive patients with recurrent atrial fibrillation. This might be related to possible favorable impact of angiotensin II receptor blockers (ARB) on the atrial electrical and structural remodeling in this type of patients.
Authors:
Roberto Fogari; Amedeo Mugellini; Maurizio Destro; Luca Corradi; Annalisa Zoppi; Elena Fogari; Andrea Rinaldi
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of cardiovascular pharmacology     Volume:  47     ISSN:  0160-2446     ISO Abbreviation:  J. Cardiovasc. Pharmacol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-20     Completed Date:  2006-05-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7902492     Medline TA:  J Cardiovasc Pharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  46-50     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine and Therapeuthics, Clinica Medica II, IRCCS Policlinico S.Matteo, University of Pavia, Pavia, Italy. r.fogari@smatteo.pv.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Amlodipine / therapeutic use
Antihypertensive Agents / therapeutic use*
Atrial Fibrillation / prevention & control*
Double-Blind Method
Female
Follow-Up Studies
Humans
Hypertension / complications,  drug therapy*
Losartan / adverse effects,  therapeutic use*
Male
Middle Aged
Recurrence
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 114798-26-4/Losartan; 88150-42-9/Amlodipine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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