Telmisartan significantly reduced the recurrence of atrial fibrillation episodes compared to carvedilol (14.3% vs. 37.1%; p<0.003) in hypertensive patients.
RCT (n=132)
Yes
Does telmisartan reduce atrial fibrillation recurrence compared to carvedilol in mild hypertensive outpatients with a history of AF?
Telmisartan is significantly more effective than carvedilol in preventing recurrent atrial fibrillation in hypertensive patients, independent of its blood pressure-lowering effects.
Absolute Event Rate: 14.3% vs 37.1%
p-value: p=<0.003
INTRODUCTION: Atrial remodelling, leading to atrial fibrillation (AF), is mediated by the renin-angiotensin-aldosterone system. METHODS: Mild hypertensive outpatients (systolic/diastolic blood pressure 140-159/90-99 mmHg) in sinus rhythm who had experienced ≥ 1 electrocardiogram (ECG)-documented AF episode in the previous six months received randomly telmisartan 80 mg/day or carvedilol 25 mg/day. Blood pressure and 24-hour ECG were monitored monthly for one year; patients were asked to report symptomatic AF episodes and to undergo an ECG as early as possible. RESULTS: One hundred and thirty-two patients completed the study (telmisartan, n=70; carvedilol, n=62). Significantly fewer AF episodes were reported with telmisartan versus carvedilol (14.3% vs. 37.1%; p<0.003). Left atrial diameter, assessed by echocardiography, was similar with telmisartan and carvedilol (3.4±2.3 cm vs. 3.6±2.4 cm). At study end, both regimes significantly reduced mean left ventricular mass index, but the reduction obtained with telmisartan was significantly greater than with carvedilol (117.8±10.7 vs. 124.7±14.5; p<0.0001). Mean blood pressure values were not significantly different between the groups (telmisartan 154/97 to 123/75 mmHg; p<0.001; carvedilol 153/94 to 125/78 mmHg; p<0.001). CONCLUSIONS: Telmisartan was significantly more effective than carvedilol in preventing recurrent AF episodes in hypertensive AF patients, despite a similar lowering of blood pressure.
Galzerano et al. (Mon,) conducted a rct in Hypertension and Atrial Fibrillation (n=132). Telmisartan vs. Carvedilol 25 mg/day was evaluated on Recurrent atrial fibrillation episodes (p=<0.003). Telmisartan significantly reduced the recurrence of atrial fibrillation episodes compared to carvedilol (14.3% vs. 37.1%; p<0.003) in hypertensive patients.
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