Antihypertensive Drug Usage in Prediction of Incident Atrial Fibrillation A Factor Not to Be Disregarded

The Dutch PREVEND (Prevention of Renal and Vascular End-Stage Disease) cohort study (1) reported both the risk factors for atrial fibrillation (AF) and the association of AF with cardiovascular events, heart failure, and all-cause mortality. At a mean 9.7 years of follow-up of more than 8,000 middle-aged men and women, 265 cases of AF were confirmed. A greater focus was given to associations with outcome than to determinants of AF, perhaps because no unexpected factors were perceived by the investigators to emerge. However, one of the main reported findings was related to the use of antihypertensive drugs. Age- and sex-adjusted Cox regression models indicated that antihypertensive drug use was a prominent and highly significant determining variable of incident AF, with a more than 2-fold hazard ratio (HR). At 32%, antihypertensive drug use led the population-attributable risk estimates of reversible or treatable factors (i.e., beyond age and male sex), and this percentage was greater than the aggregate of the next 3 factors (previous myocardial infarction, previous stroke, and obesity). Nonetheless, authors noted that body mass index was strongly associated with AF, thereby overlooking the potential and seemingly paradoxical role of antihypertensive drug use.
Source: Journal of the American College of Cardiology - Category: Cardiology Source Type: research