Angiotensin receptor blockers were superior to calcium channel blockers for preventing atrial fibrillation recurrence in patients with hypertension and AF (OR 0.43; 95% CI 0.30-0.72; P=0.0006).
Meta-Analysis (n=1,495)
Does angiotensin receptor blocker (ARB) therapy reduce atrial fibrillation recurrence in patients with hypertension and atrial fibrillation compared to calcium channel blockers (CCB)?
In patients with hypertension and atrial fibrillation, ARBs significantly reduce the risk of AF recurrence compared to CCBs.
Effect estimate: OR 0.43 (95% CI 0.30-0.72)
p-value: p=0.0006
Background. Atrial fibrillation (AF) is the most common serious cardiac rhythm disturbances and is responsible for substantial morbidity and mortality in general population. Hypertension is the most prevalent and potentially modifiable risk factor for AF. This study is aimed at evaluating the effect of angiotensin receptor blocker (ARB) or calcium channel blocker (CCB) on AF recurrence among patients with hypertension and AF. Methods. The PubMed, EMBASE, Medline, and Cochrane Collaboration of Controlled Clinical Trials registry databases were searched from their inception to September 2020. Results. A total of 7 randomized controlled trials (RCTs) enrolling 1495 patients were included in our study. This finding showed that ARB had a statistically significant superiority in preventing AF recurrence (OR: 0.43, 95% CI: 0.30-0.72, P = 0.0006 ) and persistent AF (OR: 0.41, 95% CI: 0.24-0.71, P = 0.001 ) compared to CCB. Subgroup analysis showed that there was a significant difference in telmisartan subgroup (OR: 0.54, 95% CI: 0.23-1.29, P = 0.17 ) and nontelmisartan subgroup (OR: 0.42, 95% CI: 0.23-0.77, P = 0.005 ). Subgroup analysis indicated that nifedipine subgroup did not show a statistically significant difference on AF recurrence between ARB and CCB (OR: 0.88, 95% CI: 0.46-1.68, P = 0.69 ), but amlodipine subgroup showed that ARB had a significant superiority in prevention of AF recurrence (OR: 0.39, 95% CI: 0.27-0.56, P 0.0001 ) compared with CCB. Conclusions. This study suggests that ARB is superior to CCB for preventing the AF recurrence and persistent AF among patients with hypertension and AF.
Ma et al. (2021) conducted a meta-analysis in Hypertension and Atrial Fibrillation (n=1,495). Angiotensin receptor blocker (ARB) vs. Calcium channel blocker (CCB) was evaluated on Atrial fibrillation recurrence (OR 0.43, 95% CI 0.30-0.72, p=0.0006). Angiotensin receptor blockers were superior to calcium channel blockers for preventing atrial fibrillation recurrence in patients with hypertension and AF (OR 0.43; 95% CI 0.30-0.72; P=0.0006).