Antihypertensive therapy prevents new-onset Afib in isolated systolic hypertension

  • Larstorp ACK & al.
  • Blood Press
  • 1 Jul 2019

  • curated by Sarfaroj Khan
  • UK Clinical Digest
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Takeaway

  • The effect of in-treatment systolic blood pressure (SBP) reduction in preventing incident atrial fibrillation (Afib) was stronger in patients with isolated systolic hypertension (ISH) compared with non-ISH patients with hypertension and electrocardiographic (ECG)-left ventricular hypertrophy (LVH).

Why this matters

  • Findings are in line with that of previous studies showing the benefits of blood pressure lowering therapy and ECG-LVH regression in preventing cardiovascular mortality, myocardial infarction, cerebral stroke and heart failure in the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study participants with ISH.

Study design

  • This study included 1248 patients with ISH and 7583 without ISH who participated in the LIFE study.
  • Incidence of new-onset Afib was evaluated based on ECGs performed at baseline, at 6 months and at yearly follow-up intervals.
  • Funding: MSD.

Key results

  • Overall, the incidence of new-onset Afib was reported in 61 (4.9%) and 292 (3.9%) patients with and without ISH, respectively.
  • After adjustment for confounders, per 10 mmHg reduction in SBP was associated with a lower risk for new-onset Afib in patients with ISH (HR, 0.83; 95% CI, 0.73-0.95; P=.008) and in those without ISH (HR, 0.91; 95% CI, 0.85-0.97; P=.006), independent of treatment modality, baseline risk factors, baseline SBP and in-treatment heart rate and ECG-LVH.
  • The effect of in-treatment SBP reduction in preventing incident Afib was stronger in patients with ISH than those without ISH (P=.041).

Limitations

  • Post-hoc analysis.

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