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2016 ; 95
(20
): e3721
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English Wikipedia
Angiotensin-Receptor Blocker, Angiotensin-Converting Enzyme Inhibitor, and Risks
of Atrial Fibrillation: A Nationwide Cohort Study
#MMPMID27196491
Hsieh YC
; Hung CY
; Li CH
; Liao YC
; Huang JL
; Lin CH
; Wu TJ
Medicine (Baltimore)
2016[May]; 95
(20
): e3721
PMID27196491
show ga
Both angiotensin-receptor blockers (ARB) and angiotensin-converting enzyme
inhibitors (ACEI) have protective effects against atrial fibrillation (AF). The
differences between ARB and ACEI in their effects on the primary prevention of AF
remain unclear. This study compared ARB and ACEI in combined antihypertensive
medications for reducing the risk of AF in patients with hypertension, and
determined which was better for AF prevention in a nationwide cohort
study.Patients aged ?55 years and with a history of hypertension were identified
from Taiwan National Health Insurance Research Database. Medical records of
25,075 patients were obtained, and included 6205 who used ARB, 8034 who used
ACEI, and 10,836 nonusers (no ARB or ACEI) in their antihypertensive regimen. Cox
regression models were applied to estimate the hazard ratio (HR) for new-onset
AF.During an average of 7.7 years' follow-up, 1619 patients developed new-onset
AF. Both ARB (adjusted HR: 0.51, 95% CI 0.44-0.58, P?0.001) and ACEI (adjusted
HR: 0.53, 95% CI 0.47-0.59, P?0.001) reduced the risk of AF compared to
nonusers. Subgroup analysis showed that ARB and ACEI were equally effective in
preventing new-onset AF regardless of age, gender, the presence of heart failure,
diabetes, and vascular disease, except for those with prior stroke or transient
ischemic attack (TIA). ARB prevents new-onset AF better than ACEI in patients
with a history of stroke or TIA (log-rank P?=?0.012).Both ARB and ACEI reduce
new-onset AF in patients with hypertension. ARB prevents AF better than ACEI in
patients with a history of prior stroke or TIA.
|Aged
[MESH]
|Angiotensin Receptor Antagonists/*therapeutic use
[MESH]
|Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
[MESH]
|Antihypertensive Agents/*therapeutic use
[MESH]
|Atrial Fibrillation/*epidemiology/*prevention & control
[MESH]
|Comorbidity
[MESH]
|Drug Prescriptions/statistics & numerical data
[MESH]