|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
|
|
|
|||||||||
|
|||||||||||
|
J Am Coll Cardiol, 2005; 45:712-719, doi:10.1016/j.jacc.2004.10.068 © 2005 by the American College of Cardiology Foundation |
,*
* Department of Medicine, Glostrup University Hospital, Glostrup, Denmark
Division of Cardiology, Weill Medical College of Cornell University, New York, New York
Department of Cardiology, Helsinki University Central Hospital, Helsinki, Finland
Department of Cardiology, Haukeland University Hospital, Bergen, Norway
|| Department of Medicine, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
¶ Department of Medicine, University of Michigan, Ann Arbor, Michigan
# Department of Medicine, Ullevål University Hospital, Oslo, Norway
** Department of Preventive Medicine, Umeå University Hospital, Umeå, Sweden
Manuscript received May 27, 2004; revised manuscript received September 20, 2004, accepted October 26, 2004.
* Reprint requests and correspondence: Dr. Kristian Wachtell, Rigshospitalet, Department of Medicine B2142, 9 Blegdamsvej, DK-2100 Copenhagen, Denmark (Email: kristian{at}wachtell.net).
OBJECTIVES: This study was designed to evaluate whether different antihypertensive treatment regimens with similar blood pressure reduction have different effects on new-onset atrial fibrillation (AF).
BACKGROUND: It is unknown whether angiotensin II receptor blockade is better than beta-blockade in preventing new-onset AF.
METHODS: In the Losartan Intervention For Endpoint reduction in hypertension (LIFE) study 9,193 hypertensive patients and patients with electrocardiogram-documented left ventricular hypertrophy were randomized to once-daily losartan- or atenolol-based antihypertensive therapy. Electrocardiograms were Minnesota coded centrally, and 8,851 patients without AF by electrocardiogram or history, who were thus at risk of developing AF, were followed for 4.8 ± 1.0 years.
RESULTS: New-onset AF occurred in 150 patients randomized to losartan versus 221 to atenolol (6.8 vs. 10.1 per 1,000 person-years; relative risk 0.67, 95% confidence interval [CI] 0.55 to 0.83, p < 0.001) despite similar blood pressure reduction. Patients receiving losartan tended to stay in sinus rhythm longer (1,809 ± 225 vs. 1,709 ± 254 days from baseline, p = 0.057) than those receiving atenolol. Moreover, patients with new-onset AF had two-, three- and fivefold increased rates, respectively, of cardiovascular events, stroke, and hospitalization for heart failure. There were fewer composite end points (n = 31 vs. 51, hazard ratio = 0.60, 95% CI 0.38 to 0.94, p = 0.03) and strokes (n = 19 vs. 38, hazard ratio = 0.49, 95% CI 0.29 to 0.86, p = 0.01) in patients who developed new-onset AF in the losartan compared to the atenolol treatment arm of the study. Furthermore, Cox regression analysis showed that losartan (21% risk reduction) and new-onset AF both independently predicted stroke even when adjusting for traditional risk factors.
CONCLUSIONS: Our novel finding is that new-onset AF and associated stroke were significantly reduced by losartan- compared to atenolol-based antihypertensive treatment with similar blood pressure reduction.
| |||||||||
This article has been cited by other articles:
|
|
 |
|
  E. Aliot and J. N. Ruskin Controversies in ablation of atrial fibrillation Eur. Heart J. Suppl., September 1, 2008; 10(suppl_H): H32 - H54. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Dorian and B. N. Singh Upstream therapies to prevent atrial fibrillation Eur. Heart J. Suppl., September 1, 2008; 10(suppl_H): H11 - H31. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Lopez-Jimenez, M. Camafort, G. Tiberio, J. A. Carmona, C. Guijarro, F. Martinez-Penalver, M. Monreal, and FRENA Investigators Secondary Prevention of Arterial Disease in Very Elderly People: Results From a Prospective Registry (FRENA) Angiology, August 1, 2008; 59(4): 427 - 434. [Abstract] [PDF]
|
|
|
|
 |
|
 J. L. Serra and M. Bendersky Review: Atrial fibrillation and renin-angiotensin system Therapeutic Advances in Cardiovascular Disease, June 1, 2008; 2(3): 215 - 223. [Abstract] [PDF]
|
|
|
|
 |
|
 T. D. Vagaonescu, A. C. Wilson, and J. B. Kostis Atrial Fibrillation and Isolated Systolic Hypertension: The Systolic Hypertension in the Elderly Program and Systolic Hypertension in the Elderly Program-Extension Study Hypertension, June 1, 2008; 51(6): 1552 - 1556. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Goette, A. Bukowska, U. Lendeckel, M. Erxleben, M. Hammwohner, D. Strugala, J. Pfeiffenberger, F.-W. Rohl, C. Huth, M. P.A. Ebert, et al. Angiotensin II Receptor Blockade Reduces Tachycardia-Induced Atrial Adhesion Molecule Expression Circulation, February 12, 2008; 117(6): 732 - 742. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Casaclang-Verzosa, B. J. Gersh, and T. S.M. Tsang Structural and functional remodeling of the left atrium: clinical and therapeutic implications for atrial fibrillation. J. Am. Coll. Cardiol., January 1, 2008; 51(1): 1 - 11. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. M. Kim, H. Kattach, C. Ratnatunga, R. Pillai, K. M. Channon, and B. Casadei Association of atrial nicotinamide adenine dinucleotide phosphate oxidase activity with the development of atrial fibrillation after cardiac surgery. J. Am. Coll. Cardiol., January 1, 2008; 51(1): 68 - 74. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 F. G. Cosio, E. Aliot, G. L. Botto, H. Heidbuchel, C. J. Geller, P. Kirchhof, J.-C. De Haro, R. Frank, J. P. Villacastin, J. Vijgen, et al. Delayed rhythm control of atrial fibrillation may be a cause of failure to prevent recurrences: reasons for change to active antiarrhythmic treatment at the time of the first detected episode Europace, January 1, 2008; 10(1): 21 - 27. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Kirchhof, A. Auricchio, J. Bax, H. Crijns, J. Camm, H.-C. Diener, A. Goette, G. Hindricks, S. Hohnloser, L. Kappenberger, et al. Outcome parameters for trials in atrial fibrillation: executive summary: Recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NETwork (AFNET) and the European Heart Rhythm Association (EHRA) Eur. Heart J., November 2, 2007; 28(22): 2803 - 2817. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Kirchhof, A. Auricchio, J. Bax, H. Crijns, J. Camm, H.-C. Diener, A. Goette, G. Hindricks, S. Hohnloser, L. Kappenberger, et al. Outcome parameters for trials in atrial fibrillation: Recommendations from a consensus conference organized by the German Atrial Fibrillation Competence NETwork and the European Heart Rhythm Association Europace, November 1, 2007; 9(11): 1006 - 1023. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members:, G. Mancia, G. De Backer, A. Dominiczak, R. Cifkova, R. Fagard, G. Germano, G. Grassi, A. M. Heagerty, S. E. Kjeldsen, et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) Eur. Heart J., June 11, 2007; (2007) ehm236v1. [Full Text] [PDF]
|
|
|
|
 |
|
 E. Saygili, O. R. Rana, E. Saygili, H. Reuter, K. Frank, R. H. G. Schwinger, J. Muller-Ehmsen, and C. Zobel Losartan prevents stretch-induced electrical remodeling in cultured atrial neonatal myocytes Am J Physiol Heart Circ Physiol, June 1, 2007; 292(6): H2898 - H2905. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. L. Reudelhuber, K. E. Bernstein, and P. Delafontaine Is Angiotensin II a Direct Mediator of Left Ventricular Hypertrophy?: Time for Another Look Hypertension, June 1, 2007; 49(6): 1196 - 1201. [Full Text] [PDF]
|
|
|
|
|
|
A. Berruezo, D. Tamborero, L. Mont, B. Benito, J. M. Tolosana, M. Sitges, B. Vidal, G. Arriagada, F. Mendez, M. Matiello, et al. Pre-procedural predictors of atrial fibrillation recurrence after circumferential pulmonary vein ablation Eur. Heart J., April 1, 2007; 28(7): 836 - 841. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E.W. Hemels, A. C.P. Wiesfeld, D. J. Van Veldhuisen, M. P. Van den Berg, and I. C. Van Gelder Outcome of pharmacological rhythm control for new-onset persistent atrial fibrillation in patients with systolic heart failure: a comparison with patients with normal left ventricular function Europace, April 1, 2007; 9(4): 239 - 245. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Shiroshita-Takeshita, B. J.J.M. Brundel, B. Burstein, T.-K. Leung, H. Mitamura, S. Ogawa, and S. Nattel Effects of simvastatin on the development of the atrial fibrillation substrate in dogs with congestive heart failure Cardiovasc Res, April 1, 2007; 74(1): 75 - 84. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Guler, C. Ozkara, H. Dulger, V. Kutay, M. Sahin, E. Erbilen, and H. A. Gumrukcuoglu Do Cardiac Neuropeptides Play a Role in the Occurrence of Atrial Fibrillation After Coronary Bypass Surgery? Ann. Thorac. Surg., February 1, 2007; 83(2): 532 - 537. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Gerdts, K. Wachtell, P. Omvik, J. E. Otterstad, L. Oikarinen, K. Boman, B. Dahlof, and R. B. Devereux Left Atrial Size and Risk of Major Cardiovascular Events During Antihypertensive Treatment: Losartan Intervention for Endpoint Reduction in Hypertension Trial Hypertension, February 1, 2007; 49(2): 311 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Williams The Year in Hypertension J. Am. Coll. Cardiol., October 17, 2006; 48(8): 1698 - 1711. [Full Text] [PDF]
|
|
|
|
 |
|
 P. M. Okin, K. Wachtell, R. B. Devereux, K. E. Harris, S. Jern, S. E. Kjeldsen, S. Julius, L. H. Lindholm, M. S. Nieminen, J. M. Edelman, et al. Regression of electrocardiographic left ventricular hypertrophy and decreased incidence of new-onset atrial fibrillation in patients with hypertension. JAMA, September 13, 2006; 296(10): 1242 - 1248. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Writing Committee Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 651 - 745. [Full Text] [PDF]
|
|
|
|
|
|
V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society J. Am. Coll. Cardiol., August 15, 2006; 48(4): 854 - 906. [Full Text] [PDF]
|
|
|
|
|
|
V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society J. Am. Coll. Cardiol., August 15, 2006; 48(4): e149 - e246. [Full Text] [PDF]
|
|
|
|
|
|
V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society Circulation, August 15, 2006; 114(7): e257 - e354. [Full Text] [PDF]
|
|
|
|
|
|
V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation--Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society Circulation, August 15, 2006; 114(7): 700 - 752. [Full Text] [PDF]
|
|
|
|
|
|
Authors/Task Force Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation executive summary: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Eur. Heart J., August 2, 2006; 27(16): 1979 - 2030. [Full Text] [PDF]
|
|
|
|
 |
|
 G. Y H Lip and A. Tello-Montoliu Management of atrial fibrillation. Heart, August 1, 2006; 92(8): 1177 - 1182. [Full Text] [PDF]
|
|
|
|
 |
|
 P. A Meredith and J. Ostergren Review: From Hypertension to Heart Failure -- Are There Better Primary Prevention Strategies? Journal of Renin-Angiotensin-Aldosterone System, June 1, 2006; 7(2): 64 - 73. [Abstract] [PDF]
|
|
|
|
|
|
N. Poulter, A. D Hughes, B. Williams, A. J. Brady, and G. McInnes Angiotensin-Converting Enzyme Inhibitors Versus Angiotensin Receptor Blockers: A mini-symposium held at the British Hypertension Society Meeting, September 2005 Journal of Renin-Angiotensin-Aldosterone System, June 1, 2006; 7(2): 104 - 121. [PDF]
|
|
|
|
|
|
M. Strandberg, M.J. P. Raatikainen, M. Niemela, M. Luotolahti, J. Hartiala, and K.E. J. Airaksinen Clinical practicality and predictive value of transoesophageal echocardiography in early cardioversion of atrial fibrillation Europace, June 1, 2006; 8(6): 408 - 412. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. G. Olsson, K. Swedberg, A. Ducharme, C. B. Granger, E. L. Michelson, J. J.V. McMurray, M. Puu, S. Yusuf, M. A. Pfeffer, and on behalf of the CHARM Investigators Atrial Fibrillation and Risk of Clinical Events in Chronic Heart Failure With and Without Left Ventricular Systolic Dysfunction: Results From the Candesartan in Heart failure-Assessment of Reduction in Mortality and morbidity (CHARM) Program J. Am. Coll. Cardiol., May 16, 2006; 47(10): 1997 - 2004. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Sheridan and N. Baldwin Impact of ASCOT on hypertension treatment and guidelines in older adults. Age Ageing, May 1, 2006; 35(3): 214 - 217. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Volpe, G. Tocci, and E. Pagannone Fewer Mega-Trials and More Clinically Oriented Studies in Hypertension Research? The Case of Blocking the Renin-Angiotensin-Aldosterone System. J. Am. Soc. Nephrol., April 1, 2006; 17(4_suppl_2): S36 - S43. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R. Ehrlich, S. H. Hohnloser, and S. Nattel Role of angiotensin system and effects of its inhibition in atrial fibrillation: clinical and experimental evidence Eur. Heart J., March 1, 2006; 27(5): 512 - 518. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. J. Boos and G. Y.H. Lip Prevention of Atrial Fibrillation by Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers J. Am. Coll. Cardiol., February 21, 2006; 47(4): 889 - 890. [Full Text] [PDF]
|
|
|
|
|
|
A. N. DeMaria, O. Ben-Yehuda, D. Berman, G. K. Feld, G. S. Ginsburg, B. H. Greenberg, W. Y.W. Lew, D. Sahn, and S. Tsimikas Highlights of the Year in JACC 2005 J. Am. Coll. Cardiol., January 3, 2006; 47(1): 184 - 202. [Full Text] [PDF]
|
|
|
|
|
|
C. J. Boos, R. A. Anderson, and G. Y.H. Lip Is atrial fibrillation an inflammatory disorder? Eur. Heart J., January 2, 2006; 27(2): 136 - 149. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Kalus, C. I. Coleman, and C. M. White The Impact of Suppressing the Renin-Angiotensin System on Atrial Fibrillation J. Clin. Pharmacol., January 1, 2006; 46(1): 21 - 28. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ogimoto, Y. Shigematsu, Y. Hara, T. Ohtsuka, T. Miki, and J. Higaki Black Pearl in the LIFE Study: Angiotensin-II Receptor Blockade on Atrial Fibrillation for Future Personalized Medicine J. Am. Coll. Cardiol., October 18, 2005; 46(8): 1585 - 1585. [Full Text] [PDF]
|
|
|
|
|
|
K. Wachtell, M. Lehto, E. Gerdts, M. H. Olsen, B. Hornestam, B. Dahlof, H. Ibsen, S. Julius, S. E. Kjeldsen, L. H. Lindholm, et al. Reply J. Am. Coll. Cardiol., October 18, 2005; 46(8): 1585 - 1586. [Full Text] [PDF]
|
|
|
|
|
|
J. S. Healey, A. Baranchuk, E. Crystal, C. A. Morillo, M. Garfinkle, S. Yusuf, and S. J. Connolly Prevention of Atrial Fibrillation With Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers: A Meta-Analysis J. Am. Coll. Cardiol., June 7, 2005; 45(11): 1832 - 1839. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. E. Strandberg Editorial Comment: Secondary Prevention of Stroke Is Important: But All Hypertensive Drugs Are Not Created Equal? Stroke, June 1, 2005; 36(6): 1225 - 1226. [Full Text] [PDF]
|
|
| HOME | SUBSCRIPTIONS | CURRENT ISSUE | PAST ISSUES | CARDIOSOURCE | SEARCH | HELP | FEEDBACK |
