Angiotensin-Receptor Blocker, Angiotensin-Converting Enzyme Inhibitor, and Risks of Atrial Fibrillation
Key result
Both ARB (HR 0.51; 95% CI 0.44-0.58) and ACEI (HR 0.53; 95% CI 0.47-0.59) reduced the risk of new-onset atrial fibrillation compared to nonusers in patients with hypertension.
Why the study?
Do ARBs or ACEIs reduce the risk of new-onset atrial fibrillation compared to nonusers in patients aged ≥55 years with hypertension?
Population
25,075 patients aged ≥55 years with a history of hypertension from the Taiwan National Health Insurance…
Comparison
Angiotensin-receptor blockers or… vs Nonusers in their antihypertensive regimen
Design
Cohort
Follow-up
average 7.7 years
Authors
Discussion
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Implication
ARBs/ACEIs were associated with lower new-onset AF in hypertension; extends observational data but leaves open need for RCTs before practice change.
Study Design
Type
Cohort (n=25,075)
Multicenter
Yes
Structured PICO
Do ARBs or ACEIs reduce the risk of new-onset atrial fibrillation compared to nonusers in patients aged ≥55 years with hypertension?
P
Population
25,075 patients aged ≥55 years with a history of hypertension, followed for an average of 7.7 years.
E
Exposure
Angiotensin-receptor blockers (ARB) (n=6,205) or angiotensin-converting enzyme inhibitors (ACEI) (n=8,034) as part of an antihypertensive regimen
C
Comparator
Nonusers (no ARB or ACEI) in their antihypertensive regimen (n=10,836)
O
Outcome
New-onset atrial fibrillationhard clinical
Main Result
Hazard Ratio: 0.51 (95% CI 0.44–0.58)
p-value: p=<0.001
Both ARBs and ACEIs are effective for the primary prevention of atrial fibrillation in hypertensive patients, with ARBs potentially offering greater benefit in those with a history of stroke or TIA.
Cite This Study
Hsieh et al. (2016) conducted a cohort in hypertension (n=25,075). Angiotensin-receptor blockers (ARB) vs. nonusers was evaluated on new-onset AF (HR 0.51, 95% CI 0.44-0.58, p=<0.001). Both ARB (HR 0.51; 95% CI 0.44-0.58) and ACEI (HR 0.53; 95% CI 0.47-0.59) reduced the risk of new-onset atrial fibrillation compared to nonusers in patients with hypertension.