Document Detail


Risk for incident atrial fibrillation in patients who receive antihypertensive drugs: a nested case-control study.
MedLine Citation:
PMID:  20083826     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Beat A Schaer; Cornelia Schneider; Susan S Jick; David Conen; Stefan Osswald; Christoph R Meier
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of internal medicine     Volume:  152     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-01-19     Completed Date:  2010-01-26     Revised Date:  2013-06-25    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  78-84     Citation Subset:  AIM; IM    
Affiliation:
University Hospital, Basel, Switzerland.
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MeSH Terms
Descriptor/Qualifier:
Adrenergic beta-Antagonists / 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:
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:
Ann Intern Med. 2010 Jan 19;152(2):I-16   [PMID:  20083810 ]

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


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