Candesartan in the prevention of relapsing atrial fibrillation

Tveit, Arnljot; Grundvold, Irene; Olufsen, Mona; Seljeflot, Ingebjørg; Abdelnoor, Michael; Arnesen, Harald; Smith, Pål

doi:10.1016/j.ijcard.2006.08.086

Cited by 101 publications

(87 citation statements)

References 23 publications

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“…In patients with persistent AF, the use of enalapril 51 or irbesartan 52 in addition to amiodarone reduced the risk of AF recurrence over amiodarone alone after electrical and/or pharmacological cardioversion. On the other hand, the use of ACEIs 53 or candesartan 54 alone without antiarrhythmic agents failed to reduce the risk of AF recurrence after cardioversion. However, in these studies, o50% of patients had hypertension.…”

Section: Raas Activationmentioning

confidence: 99%

Hypertension and atrial fibrillation: epidemiology, pathophysiology and therapeutic implications

Yiu

Siu

et al. 2011

J Hum Hypertens

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Hypertension is one of the most important risk factors associated with atrial fibrillation (AF) and increased the risk of cardiovascular events in patients with AF. However, the pathophysiological link between hypertension and AF is unclear. Nevertheless, this can be explained by the hemodynamic changes of the left atrium secondary to long standing hypertension, resulting in elevated left atrium pressure and subsequently left atrial enlargement. Moreover, the activation of renin --angiotensin --aldosterone system (RAAS) activation in patients with hypertension induces left atrial fibrosis and conduction block in the left atrium, resulting in the development of AF. Accordingly, recent studies have shown that effective blockage of RAAS by angiotensin converting enzyme inhibitors or angiotensin receptor antagonist may be effective in both primary and secondary prevention of AF in patients with hypertension, although with controversies. In addition, optimal antithrombotic therapy, blood pressure control as well as rate control for AF are key to the management of patients with AF. 1,2 Both hypertension 3 and AF 4 have increased frequency with the ageing population worldwide, and are associated with increased cardiovascular events. They are important risk factors for stroke, heart failure and overall mortality. 5 --7 On the other hand, hypertension is one of the important risk factors for the occurrence of AF, 8 and increased the risk of stroke and cardiovascular mortality in patients with AF.9,10 Compare with other risk factors for AF, hypertension appears to be responsible for more AF than any other risk factor because of its high prevalence. However, the pathophysiological link between AF and hypertension remains unclear. Moreover, it is also unclear whether treatment of hypertension prevents AF or reduces the risk of AF related complications. The purpose of this article is to review the epidemiology, underlying mechanisms and therapeutic implications of AF in hypertensive patients. A systematic literature search for full-text papers in the English language was performed using MEDLINE, Embase and the Cochrane library through to July 2011. In the search phrases used, the following terms were used: 'atrial fibrillation', 'hypertension', 'epidemiology', 'pathophysiology' and 'treatment'. Papers selected and cited in this review were based on the authors' view on the relevance to the manuscript. In addition, abstracts from international cardiovascular meetings were studied to identify unpublished studies.

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Section: Raas Activationmentioning

confidence: 99%

Hypertension and atrial fibrillation: epidemiology, pathophysiology and therapeutic implications

Yiu

Siu

et al. 2011

J Hum Hypertens

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“…4 -6 Rhythm control strategies for sinus rhythm maintenance are unfortunately not optimal in clinical practice. 7,8 Therefore, additional knowledge of AF prevention by identifying possible treatable risk factors has important clinical relevance. 9,10 The Framingham Heart Study, as well as other populationbased cohort studies, has shown that arterial hypertension is a strong independent risk factor for AF.…”

mentioning

confidence: 99%

Upper Normal Blood Pressures Predict Incident Atrial Fibrillation in Healthy Middle-Aged Men

Grundvold

Skretteberg²,

Liestøl³

et al. 2012

Hypertension

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139

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Abstract-Hypertension is the most prevalent risk factor for incident atrial fibrillation (AF). Recently, even high normal blood pressures (BPs) have been established as predictive of AF in women. We aimed to study the long-term impact of upper normal BP on incident AF in a population-based study of middle-aged men. From 1972From to 1975From , 2014 Key Words: arrhythmia Ⅲ cardiac disease Ⅲ epidemiology Ⅲ hypertension Ⅲ men T he incidence of atrial fibrillation (AF) is increasing in the general population. 1-3 Currently, there is growing awareness of AF as a major health problem mainly because of its strong association with heart failure and stroke. 4 -6 Rhythm control strategies for sinus rhythm maintenance are unfortunately not optimal in clinical practice. 7,8 Therefore, additional knowledge of AF prevention by identifying possible treatable risk factors has important clinical relevance. 9,10 The Framingham Heart Study, as well as other populationbased cohort studies, has shown that arterial hypertension is a strong independent risk factor for AF. 8,[11][12][13][14] Furthermore, a recent study by Conen et al showed that even systolic and diastolic blood pressure (BP) within the nonhypertensive range was independently associated with AF in a large cohort of middle-aged women. 15 Another recent study from the prospective follow-up in the Framingham cohort demonstrated that pulse pressure, reflecting arterial stiffness, was the most important predictor of AF. 16 In our study cohort, we have previously established baseline systolic BP as a strong predictor of cardiovascular death, but potential association with AF has never been assessed. 17 In the present study, we aimed to test the long-term impact of systolic BP, in particular upper normal systolic BP, on the risk of developing AF in healthy middle-aged men. Second, we aimed to assess the associations between incident AF and diastolic BP and pulse pressure. From 1972From to 1975From , 2014 apparently healthy men aged 40 to 59 years from 5 governmental institutions in Oslo were included in a prospective cardiovascular survey after careful screening of health information. The presence of any of the following diseases caused primary exclusion: known or suspected coronary heart disease; diagnosed hypertension requiring drug treatment; diabetes mellitus; thyroid disorders; cancer; advanced pulmonary, renal, or liver Continuing medical education (CME) credit is available for this article. Go to http://cme.ahajournals.org to take the quiz. Methods Study Population

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“…Этот эффект под-твержден для диуретиков, бета-блокаторов, ингибито-ров АПФ и БРА, а вот антагонисты кальция в сравни-тельных исследованиях были явно менее эффективны, филактики сосудистых событий при фибрилляции предсердий (ACTIVE I) у больных с фибрилляцией предсердий [572]. Блокаторы рецепторов ангиотензина не предотвращали рецидивы пароксизмальной или персистирующей фибрилляции предсердий (исследо-вание кандесартана в профилактике рецидива фибрил-ляции предсердий [CAPRAF,573], исследование ита-льянской группы по оценке выживаемости после инфаркта миокарда -фибрилляции предсердий [GISSI-AF, 574] и исследование антагониста ангиотен-зина II при пароксизмальной фибрилляции предсердий [ANTIPAF,575]). С учетом неоднородности существую-щих данных, было высказано предположение, что положительные эффекты блокаторов рецепторов анги-отензина могут ограничиваться предотвращением только дебюта фибрилляции предсердий у больных АГ со структурной патологией сердца, например, гипер-трофией или дисфункцией левого желудочка, либо у больных с высоким общим риском, не имеющих в анамнезе эпизодов фибрилляции предсердий [568,576].…”

Section: сердечная недостаточностьunclassified

2013 Esh/Esc Guidelines for the Management of Arterial Hypertension

Mancia

Fagard²,

Redón³

et al. 2014

Russ J Cardiol

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Авторы/члены рабочей группы: Giuseppe Mancia (сопредседатель; италия)*, Robert Fagard (сопредседатель; бельгия)*, Krzysztof Narkiewicz (координатор секции, Польша), Josep Redón (координатор секции; испания), Alberto Zanchetti (координатор секции, италия), Michael Böhm

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Candesartan in the prevention of relapsing atrial fibrillation

Cited by 101 publications

References 23 publications

Hypertension and atrial fibrillation: epidemiology, pathophysiology and therapeutic implications

Hypertension and atrial fibrillation: epidemiology, pathophysiology and therapeutic implications

Upper Normal Blood Pressures Predict Incident Atrial Fibrillation in Healthy Middle-Aged Men

2013 Esh/Esc Guidelines for the Management of Arterial Hypertension

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