Choi JungMin, Lee So-Ryoung, Choi Eue-Keun, Lee Kyung-Yeon, Ahn Hyo-Jeong, Kwon Soonil, Kim Bongseong, Han Kyung-Do, Oh Seil, Lip Gregory Y H
Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Front Cardiovasc Med. 2024 May 9;11:1372505. doi: 10.3389/fcvm.2024.1372505. eCollection 2024.
Patients with hypertension are at a high risk of atrial fibrillation (AF). Recent research has indicated the varying effects of antihypertensive medications on developing AF.
We investigated the relationship between different types of antihypertensive medications and the risk of AF occurrence.
We analyzed data from 113,582 subjects with national health screening examinations between 2009 and 2014. The study population was categorized according to antihypertensive medication type. The primary outcome was the incidence of AF.
Among 113,582 subjects (mean age 59.4 ± 12.0 years, 46.7% men), 93,557 received monotherapy [angiotensin receptor blockers (ARB), angiotensin-converting enzyme inhibitors (ACEi), beta-blockers, calcium channel blockers (CCB), or diuretics], while 34,590 received combination therapy (ARB/beta-blockers, ARB/CCB, ARB/diuretics, or ARB/CCB/diuretics). During a mean follow-up duration of 7.6 ± 2.1 years, 3.9% of patients were newly diagnosed with AF. In monotherapy, ACEi and CCB had similar AF risks as ARB, while beta-blockers and diuretics showed higher AF risks than ARB. In combination therapy, ARBs/CCBs and ARBs/diuretics had the lowest AF risk, whereas ARBs/beta-blockers had the highest compared to ARB/CCB. Among the specific ARBs, the AF risk varied insignificantly, except for telmisartan and candesartan.
In hypertensive patients receiving monotherapy, ACEi and CCB showed a similar AF risk as ARBs, while beta-blockers and diuretics were associated with a higher risk. Among those receiving combination therapy, ARBs/CCBs and ARBs/diuretics had the lowest AF risk, whereas ARBs/beta-blockers showed the highest risk. Various types of ARBs have different associations with AF risk.
高血压患者患心房颤动（AF）的风险很高。最近的研究表明，抗高血压药物对房颤发生有不同影响。
我们研究了不同类型抗高血压药物与房颤发生风险之间的关系。
我们分析了2009年至2014年期间113,582名接受国民健康筛查的受试者的数据。研究人群根据抗高血压药物类型进行分类。主要结局是房颤的发生率。
在113,582名受试者（平均年龄59.4±12.0岁，男性占46.7%）中，93,557人接受单一疗法（血管紧张素受体阻滞剂（ARB）、血管紧张素转换酶抑制剂（ACEi）、β受体阻滞剂、钙通道阻滞剂（CCB）或利尿剂），而34,590人接受联合疗法（ARB/β受体阻滞剂、ARB/CCB、ARB/利尿剂或ARB/CCB/利尿剂）。在平均随访7.6±2.1年期间，3.9%的患者被新诊断为房颤。在单一疗法中，ACEi和CCB的房颤风险与ARB相似，而β受体阻滞剂和利尿剂的房颤风险高于ARB。在联合疗法中，ARB/CCB和ARB/利尿剂的房颤风险最低，而与ARB/CCB相比，ARB/β受体阻滞剂的房颤风险最高。在特定的ARB中，除替米沙坦和坎地沙坦外，房颤风险差异不显著。
在接受单一疗法的高血压患者中，ACEi和CCB的房颤风险与ARB相似，而β受体阻滞剂和利尿剂的风险更高。在接受联合疗法的患者中，ARB/CCB和ARB/利尿剂的房颤风险最低，而ARB/β受体阻滞剂的风险最高。不同类型的ARB与房颤风险有不同的关联。
