Antihypertensive therapy reduces the risk of atrial fibrillation modestly but benefits appear to be larger in patients with heart failure , with no clear evidence of benefit in patients without heart failure .
Previous suggestions of class-specific effects could not be confirmed in this more comprehensive analysis
AIMS High blood pressure is known to be associated with future risk of atrial fibrillation .
Whether such risks can be reduced with antihypertensive therapy is less clear .
We conducted a systematic review and meta- analysis of large-scale r and omized trials that have reported the effect of antihypertensive agents on atrial fibrillation .
Reduced incidence of new-onset atrial fibrillation with angiotensin II receptor blockade: the VALUE trial
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 received valsartan 80–160 mg/day or amlodipine 5–10 mg/day combined with additional antihypertensive agents . Electrocardiograms were obtained every year and analyzed central ly 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
Antihypertensive therapy reduces the risk of atrial fibrillation modestly but benefits appear to be larger in patients with heart failure , with no clear evidence of benefit in patients without heart failure .
Previous suggestions of class-specific effects could not be confirmed in this more comprehensive analysis
AIMS High blood pressure is known to be associated with future risk of atrial fibrillation .
Whether such risks can be reduced with antihypertensive therapy is less clear .
We conducted a systematic review and meta- analysis of large-scale r and omized trials that have reported the effect of antihypertensive agents on atrial fibrillation .