Atrial fibrillation risk lower with some classes of antihypertensives

Certain classes of antihypertensive drugs may be better for reducing incident atrial fibrillation risk, according to a new study.

Researchers examined data from 4,661 patients with atrial fibrillation (AF) and 18,642 matched controls in a population of 682,993 patients treated for hypertension in the United Kingdom. Sixty-two percent of the case-patients were at least 70 years of age when diagnosed with AF, and almost half (47%) were men. Patients who had clinical risk factors for AF were excluded. The study results appeared in the Jan. 19 Annals of Internal Medicine.

The authors compared the risk for AF among hypertensive patients taking angiotensin-converting enzyme (ACE) inhibitors, angiotensin II-receptor blockers (ARBs), or beta-blockers to a reference group taking calcium-channel blockers. Current exclusive long-term therapy with ACE inhibitors (odds ratio [OR], 0.75; 95% CI, 0.65 to 0.87), ARBs (OR, 0.71; CI, 0.57 to 0.89) or beta-blockers (OR, 0.78; CI, 0.67 to 0.92) was associated with lower risk for AF than current exclusive therapy with calcium-channel blockers.

The authors noted that their findings might not apply to patients with severe hypertension requiring multidrug therapy. They also acknowledged several study limitations, including possible misclassification of AF diagnoses and concomitant use of diuretics. Although the authors called for further research to confirm their findings, they concluded that at least 12 months of therapy with ACE inhibitors, ARBs or beta-blockers reduces risk for AF compared with long-term calcium-channel blockers.