Prevention effect of atrial fibrillation recurrence in hypertensive patients by telmisartan versus nifedipine

Abstract

Objective To compare the prevention effect of atrial fibrillation recurrence in hypertensive patients by telmisartan versus nifedipine.Methods Ninety-eight cases of hypertensive with paroxysmal atrial fibrillation patients were enrolled and divided into telmisartan group and nifedipine group with 49 cases each by random digits table method.Telmisartan group was given telmisartan 80 mg/d,nifedipine group was given nifedipine 30 mg/d.Dose of the drug needed to be adjusted according to individual condition until achieving the target.Followed-up for 18 months.Observed two groups of recurrence of atrial fibrillation and the recurrence time for the first time,recorded before and after the treatment of cardiac parameters:including left atrial diameter (LAD),left ventricular end diastolic diameter(LVDD),left ventricular posterior wall thickness (LVPWT),interventricular septum thickness (IVST),left atrial volume index(LAVI) and left ventricular mass index(LVMI).Results The blood pressure after treatment in two groups was lower than that before treatment,there was statistically significant difference (P＜ 0.05),but there was no statistically significant difference between two groups (P ＞ 0.05).After treatment,the recurrence of atrial fibrillation,atrial fibrillation recurrence time for the first time in two groups had no statistical significance (P ＞ 0.05).But the incidence of persistent atrial fibrillation in telmisartan group was significantly lower than that in nifedipine group [4.1％ (2/49) vs.16.3％ (8/49)],there was statistically significant difference (P =0.045).The cardiac parameters between two groups before treatment had no significant difference (P ＞ 0.05).After treatment,the cardiac parameters in two groups were signifcantly reduced,there were statistically significant differences (P ＜ 0.05).Moreover,the LAD,LVPWT,LAVI and LVMI in telmisartan group after treatment were significantly lower than those in nifedipine group [(37.6 ± 2.9) mm vs.(38.9 ± 2.4) mm,(11.6 ± 1.0) mm vs.(12.0 ± 0.9) mm,(22.0 ± 3.6) ml/m2 vs.(23.9 ± 4.2)ml/m2,(120.4 ± 18.2) g/m2 vs.(129.5 ± 19.2) g/m2],there were statistically significant differences (P ＜ 0.05).Conclusions Nifedipine and telmisartan can effectively lower the blood pressure.But telmisartan is superior to preventing atrial fibrillation recurrences and developing in hypertensive with paroxysmal atrial fibrillation patients,promoting cardiac parameters and postponing myocardial remodeling. Key words: Hypertension; Atrial fibrillation; Nifedipine; Telmisartan