| Risk for incident atrial fibrillation in patients who receive antihypertensive drugs: a nested case-control study. | |
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MedLine Citation:
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PMID: 20083826 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Different antihypertensive drug classes may alter risk for atrial fibrillation. Some studies suggest that drugs that interfere with the renin-angiotensin system may be favorable because of their effect on atrial remodeling. OBJECTIVE: To assess and compare the relative risk for incident atrial fibrillation among hypertensive patients who receive antihypertensive drugs from different classes. DESIGN: Nested case-control analysis. SETTING: The United Kingdom-based General Practice Research Database, a well-validated primary care database comprising approximately 5 million patient records. PATIENTS: 4661 patients with atrial fibrillation and 18,642 matched control participants from a population of 682,993 patients treated for hypertension. MEASUREMENTS: A comparison of the risk for atrial fibrillation among hypertensive users of angiotensin-converting enzyme (ACE) inhibitors, angiotensin II-receptor blockers (ARBs), or beta-blockers with the reference group of users of calcium-channel blockers. Patients with clinical risk factors for atrial fibrillation were excluded. RESULTS: Current exclusive long-term therapy with ACE inhibitors (odds ratio [OR], 0.75 [95% CI, 0.65 to 0.87]), ARBs (OR, 0.71 [CI, 0.57 to 0.89]), or beta-blockers (OR, 0.78 [CI, 0.67 to 0.92]) was associated with a lower risk for atrial fibrillation than current exclusive therapy with calcium-channel blockers. LIMITATION: Blood pressure changes during treatment courses could not be evaluated, and risk for bias by indication cannot be fully excluded in an observational study. CONCLUSION: In hypertensive patients, long-term receipt of ACE inhibitors, ARBs, or beta-blockers reduces the risk for atrial fibrillation compared with receipt of calcium-channel blockers. PRIMARY FUNDING SOURCE: None. |
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Authors:
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Beat A Schaer; Cornelia Schneider; Susan S Jick; David Conen; Stefan Osswald; Christoph R Meier |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Annals of internal medicine Volume: 152 ISSN: 1539-3704 ISO Abbreviation: Ann. Intern. Med. Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-01-19 Completed Date: 2010-01-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0372351 Medline TA: Ann Intern Med Country: United States |
Other Details:
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Languages: eng Pagination: 78-84 Citation Subset: AIM; IM |
Affiliation:
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University Hospital, Basel, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use Adult Aged Angiotensin II Type 1 Receptor Blockers / therapeutic use Angiotensin-Converting Enzyme Inhibitors / therapeutic use Antihypertensive Agents / therapeutic use* Atrial Fibrillation / prevention & control* Calcium Channel Blockers / therapeutic use Case-Control Studies Female Humans Hypertension / complications, drug therapy* Male Middle Aged Regression Analysis Renin-Angiotensin System / drug effects Risk Factors Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Calcium Channel Blockers |
| Comments/Corrections | |
Summary for patients in:
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Ann Intern Med. 2010 Jan 19;152(2):I-16
[PMID:
20083810
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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