Does losartan-based treatment reduce new-onset atrial fibrillation and stroke compared to atenolol-based treatment in patients with hypertension and left ventricular hypertrophy?
Losartan-based treatment may prevent atrial fibrillation and reduce stroke risk in hypertensive patients with left ventricular hypertrophy by reducing left atrial size and LV hypertrophy.
The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study provided extensive data on predisposing factors, consequences, and prevention of atrial fibrillation (AF) in patients with hypertension and left ventricular (LV) hypertrophy. Randomized losartan-based treatment was superior to atenolol-based treatment for reducing new-onset AF and complications, especially stroke, associated with new-onset or pre-existing AF. Potential mechanisms of AF prevention by angiotensin receptor blockade supported by LIFE results include greater reduction in left atrial size and LV hypertrophy. Differential effects of antihypertensive treatment on the left atrium and left ventricle may help prevent AF and reduce risk of stroke associated with hypertensive heart disease.
Wachtell et al. (2008) studied this question.