Atrial fibrillation risk among hypertensives differs by treatment medication

January 01, 0001

Atrial fibrillation risk among hypertensives differs by treatment medication

In this case-control study Swiss and US investigators compared the relative risk for incident atrial fibrillation among hypertensive patients who receive antihypertensive drugs from different classes. They used the United Kingdom-based General Practice Research Database, a well-validated primary care database comprising approximately 5 million patient records. They included 4661 patients with atrial fibrillation and 18 642 matched controls from a population of 682 993 patients treated for hypertension.

They found: "Current exclusive long-term therapy with ACE inhibitors (OR 0.75), ARBs (OR 0.71), or beta-blockers (OR 0.78) was associated with a lower risk for atrial fibrillation than current exclusive therapy with calcium-channel blockers. Blood pressure changes during treatment courses could not be evaluated, and risk for bias by indication cannot be fully excluded in an observational study."

The authors concluded: "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."

Here is a reason to choose a class other than calcium channel blockers as first line therapy for hypertension.

For the full abstract, click here.

Ann Intern Med 152(2):78-84, 19 January 2010
© 2008 to the American Academy of Family Physicians
Risk for Incident Atrial Fibrillation in Patients Who Receive Antihypertensive Drugs-A Nested Case-Control Study. Beat A. Schaer, Cornelia Schneider, Susan S. Jick, David Conen, Stefan Osswald, and Christoph R. Meier. Correspondence to: Dr. Meier: [email protected]

Category: K. Circulatory. Keywords: hypertension, therapy, ACE inhibitors, beta-blockers, ARBs, atrial fibrillation, case-control study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio.. Posted on Global Family Doctor 2 February 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.