BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia and increases cardiovascular risk in hypertensive patients. Therefore, in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) a prespecified objective was to compare the effects of valsartan and amlodipine on new-onset AF. METHODS: A total of 15 245 hypertensive patients at high cardiovascular risk receivedvalsartan 80-160 mg/day or amlodipine 5-10 mg/day combined with additional antihypertensive agents. Electrocardiograms were obtained every year and analyzed centrally for evidence of left ventricular hypertrophy and new-onset AF. RESULTS: At baseline, AF was diagnosed in 2.6% of 7649 valsartan recipients and 2.6% of 7596 amlodipine recipients. During antihypertensive treatment the incidence of at least one documented occurrence of new-onset AF was 3.67% with valsartan and 4.34% with amlodipine [unadjusted hazard ratio 0.843, [95% confidence interval (CI): 0.713, 0.997], P = 0.0455]. The incidence of persistent AF was 1.35% with valsartan and 1.97% with amlodipine [unadjusted hazard ratio 0.683 (95% CI: 0.525, 0.889), P = 0.0046]. CONCLUSIONS:Valsartan-based treatment reduced the development of new-onset AF, particularly sustained AF in hypertensive patients, compared with amlodipine-based therapy. These findings suggest that angiotensin II receptor blockers may result in greater benefits than calcium antagonists in hypertensive patients at risk of new-onset AF.
RCT Entities:
BACKGROUND:Atrial fibrillation (AF) is the most common arrhythmia and increases cardiovascular risk in hypertensivepatients. Therefore, in the Valsartan Antihypertensive Long-term Use Evaluation (VALUE) a prespecified objective was to compare the effects of valsartan and amlodipine on new-onset AF. METHODS: A total of 15 245 hypertensivepatients at high cardiovascular risk received valsartan 80-160 mg/day or amlodipine 5-10 mg/day combined with additional antihypertensive agents. Electrocardiograms were obtained every year and analyzed centrally for evidence of left ventricular hypertrophy and new-onset AF. RESULTS: At baseline, AF was diagnosed in 2.6% of 7649 valsartan recipients and 2.6% of 7596 amlodipine recipients. During antihypertensive treatment the incidence of at least one documented occurrence of new-onset AF was 3.67% with valsartan and 4.34% with amlodipine [unadjusted hazard ratio 0.843, [95% confidence interval (CI): 0.713, 0.997], P = 0.0455]. The incidence of persistent AF was 1.35% with valsartan and 1.97% with amlodipine [unadjusted hazard ratio 0.683 (95% CI: 0.525, 0.889), P = 0.0046]. CONCLUSIONS:Valsartan-based treatment reduced the development of new-onset AF, particularly sustained AF in hypertensivepatients, compared with amlodipine-based therapy. These findings suggest that angiotensin II receptor blockers may result in greater benefits than calcium antagonists in hypertensivepatients at risk of new-onset AF.
Authors: Teresa M Seccia; Brasilina Caroccia; Gail K Adler; Giuseppe Maiolino; Maurizio Cesari; Gian Paolo Rossi Journal: Hypertension Date: 2017-04 Impact factor: 10.190
Authors: Jonathan Chrispin; Aditya Jain; Elsayed Z Soliman; Eliseo Guallar; Alvaro Alonso; Susan R Heckbert; David A Bluemke; João A C Lima; Saman Nazarian Journal: J Am Coll Cardiol Date: 2014-03-19 Impact factor: 24.094
Authors: Tyler W Barrett; Alan B Storrow; Cathy A Jenkins; Frank E Harrell; John Amdahl; Stephan Russ; Corey M Slovis; Dawood Darbar Journal: Am J Emerg Med Date: 2011-01-03 Impact factor: 2.469