medigraphic.com
ISSN 1561-3186 (Electronic)

2013, Number 1

<< Back Next >>

Rev Acta Médica 2013; 14 (1)

Prevalence of atrial fibrillation in hypertensive patients treated or not treated with angiotensin-converting enzyme inhibitor (ACE)

del Pozo JHA, Chao PC, Jiménez PR

Language: Spanish
References: 20
Page:
PDF size: 207.78 Kb.


ABSTRACT

Introduction: hypertension has been identified as the main risk factor for the appearance of atrial fibrillation which, at the same time, doubles the risk of mortality and fivefold increases the risk of stroke, apart from being the cause of cardiac insufficiency.
Objective: to analyze the prevalence of atrial fibrillation in hypertensive patients with different degrees of complexity treated or not with angiotensin-converting enzyme inhibitors, considering the beneficial properties attributed to this type of drugs.
Methods: an observational, cross-sectional study was conducted in a series of 247 hypertensive patients.
Results: diagnosis of hypertension: from 1 to 20 years, there was prevalence of atrial fibrillation in 31 patients (12.6 %), most of them belonged to group II (19/31) and those who did not present this condition belonged to group III with 95/216. In relation to the use of angiotensin-converting enzyme inhibitors and presence of atrial fibrillation: 115 patients did not use them and 9 of them presented atrial fibrillation. These inhibitors were used in 100 patients and 23 of them presented atrial fibrillation. [(Chi-Square (X2): 7.168 p=0,007, OR= 2.94, CI 95 % (1, 3-6, 6). The reason of prevalence of atrial fibrillation was: 2, 58 CI 95 % (1, 2-5, 3)]. In relation to the use of angiotensin inhibitors and another drug, only 37 patients used inhibitors and atrial fibrillation was present in 7 patients; angiotensin inhibitors and another drug were also used in 63 patients and 16 of them presented atrial fibrillation; of the 115 patients who did not use inhibitors, 9 presented atrial fibrillation.
Conclusions: although the use of angiotensin inhibitors did not show any benefits in relation to the presence of atrial fibrillation, the proven benefits of the use of these drugs make them recommended, whenever possible, in early stages of hypertension and confirm the need to achieve the target figures and act firmly in the presence of associated risk factors.


REFERENCES

  1. GdadeboTD, OkaforH, And Darbar D. Differential impact of race and risk factor son incidence of atrial fibrillation. Am Heart J. 2011;162(1):31-7.

  2. Morillas P, Pallarés V, Llisterri JL, SanchisC, Sánchez T, Fácila L, et al. Prevalencia de fibrilación auricular y uso de fármacos antitrombóticos en el paciente hipertenso  65 años. Registro FAPRES. Rev Esp Cardiol. 2010;63:943-50.

  3. Quesada Vargas O. Hipertensión arterial 2009. Actualización Médica Periódica. 2009 [consulta 26 Dic 2012];Agosto No.99. Disponible en: http://www.ampmd.com

  4. The Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Guidelines for the management of atrial fibrillation. Eur Heart J. 2010 [consulta 26 Dic 2012];DOI:10.1093/eurheartj/ehq278. Disponible en: http://www.oxfordjournals.org

  5. Moro Serrano C, Hernández-Madrid A. Fibrilación auricular: ¿estamos ante una epidemia? Rev Espcardiol. 2009;62(1):10-4.

  6. Wann LS, Curtis AB, January CT, Ellenbogen KA, Lowe UE, Estes NA, et al. ACCF/AHA/HRS.2011 ACCF/AHA/HRS focus update on management of patients with atrial fibrillation (Updating the 2008 Guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2011;57:223-42.

  7. Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR, Abhayaratna WP, et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006;114:11925.

  8. Chobanian A, Bakris GL, Black HR, Cushman W, Green LA, Ixxo JB Jr, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. The JNC 7 Report. JAMA. 2003;289:2560-72.

  9. Comisión Nacional Técnica Asesora del Programa de Hipertensión Arterial. Hipertensión Arterial. Guía para la prevención, diagnóstico y tratamiento. La Habana: Ed. Ciencias Médicas; 2008.

  10. Schaer BA, Schneider C, Jick SS, Conen D, Osswald S, Christoph R. Risk for Incident Atrial Fibrillation in Patients Who Receive Antihypertensive Drugs: A Nested CaseControl Study. Ann Intern Med. 2010;152(2):78-84.

  11. Verdecchia P, Gentile G, Angeli F, Reboldi. Evidence for Cardiovascular, Cerebrovascular, and Renal Protective Effects of Renin-Angiotensin System Blockers. Ther Adv Cardivasc Dis. 2012 [consulta 26 Dic 2012];6(2):81-91. Disponible en: http://www.medscape.com/viewarticle/763869?src=nl_topic17

  12. Alguedas JA. Valsartan para la prevención de la fibrilación atrial recurrente. Actualización Médica Periódica.2009 [consulta 26 Dic 2012];Mayo No.96. Disponible en: http://www.ampmd.com

  13. Heeringa J, Van der Kuip DA, Hofman A, Kors JA, Van Herpen G, Stricker BH, et al. Prevalence, incidence and life time risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 206;27:949-53.

  14. Kannel WB, Benjamin EJ. Epidemiology of atrial fibrillation. Med Clin North Am. 2008;92:17.

  15. Fang K. African Americans have markedly lower prevalence of atrial fibrillation despite higher prevalence of risk factors. Heart Rhythm. 2009;6(5S):S46.

  16. Quesada Vargas O. Hipertensión Arterial. Lo que todos debemos saber de los estudios más importantes. Actualización Médica. Enero 2012; No. 128. [consulta 26 Dic 2012]. Disponible en: http://ww.ampmd.com

  17. Weir MR. Effects of renin-angiotensin system inhibition on end-organ protection: can we do better? ClinTher. 2007;29(9):1803-24.

  18. Zamani P, Ganz P, Libby P, Sutradhar S,Rifai N, Nicholls SJ, et al. Relationship of antihypertensive treatment to plasma markers of vascular inflammation and remodeling in the comparison of amlodipineversusenalapril to Limit Occurrences of Thrombosis Study. Am Heart J. 2012;163(4):735-40.

  19. Van Vark LC, Bertrand M, Akkerhuis M, Brugts J. Angiotensin-converting enzyme inhibitors reduce mortality in hypertension: a meta-analysis of randomized clinical trials of rennin-angiotensin-aldosterone system inhibitors. European Heart Journal. Doi:10.1093/eurheartj/ehs075. [consulta 26 Dic 2012]. Disponible en: http://eurheartj.oxford/journals.org/at

  20. Morillasa P, de Andrade H, Castilloa J, Quilesa J, Bertomeu-González V. Inflamacióny apoptosis en la hipertensión arterial. Importancia de la extensión de la lesión de órgano. Rev Esp Cardiol. 2012;65(9):819-625.




2020     |     www.medigraphic.com