Effect of Telmisartan on Atrial Fibrillation Recurrences in Patients with Hypertension: A Systematic Review and Meta‐Analysis

Abstract

SUMMARYBackground: The systematic review and meta-analysis are to evaluate the effect of t Telmisartan on atrial fibrillation (AF) recurrences in hypertensive patients with paroxysmal AF. Methods: MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched. Random controlled trials (RCTs) were conducted in which telmisartan was compared to other antihypertensive drugs for AF recurrences prevention in hypertensive patients with paroxysmal AF. A systematic review and meta-analysis based on aggregate data extracted from the included studies were carried out to assess the telmisartan in preventing AF relapse. The efficacy outcome was the incidence of AF recurrences. Hazard ratios (HRs) were calculated from published summary statistics and combined to give pooled estimates of efficacy. Results: This meta-analysis comprised four studied including 1050 hypertensive patients (537 men and 513 women; mean age 63; mean blood pressure (BP) 156/94 mmHg). With the similar BP control, the AF recurrences rate was significantly lower in the telmisartan-treated patients than in the other antihypertensive drugs-treated patients (HR 0.54, CI 0.34-0.86, P < 0.05). Conclusion: The results of this review and meta-analysis indicate that telmisartan seems to be more effective than other antihypertensive drugs in preventing AF recurrences among hypertensive patients with paroxysmal AF.

Genetic variants associated with risk of atrial fibrillation regulate expression of PITX2, CAV1, MYOZ1, C9orf3 and FANCC

“…Our results suggest further clinical evaluation of pioglitazone and other PPARγ agonists in prevention of AF is warranted. Furthermore, telmisartan, an angiotensin II receptor which is, uniquely in its class, a partial PPARγ agonist, appears to be more effective than other antihypertensives at preventing AF [24,25]; clinical studies focused specifically on the capacity of telmisartan to affect AF risk would be of interest.…”

Obesity and atrial fibrillation: A comprehensive review of the pathophysiological mechanisms and links

“…It was shown that increased inflammatory cytokines (TNFa, IL-6, IL-1) were associated with atrial remodeling leading to the development of AF while PPARa was negatively correlated with these inflammatory cytokines [52]. Notably, ACE inhibitors and angiotensin receptor blockers (ARBs) appear to be effective in primary [53] and secondary [54,55] prevention of AF.…”

Current Evidence-Based Understanding of the Epidemiology, Prevention, and Treatment of Atrial Fibrillation

“…53 A recent metaanalysis of 4 randomized clinical trials (RCTs) with 1050 patients showed telmisartan was more effective than other antihypertensive medications in reducing the burden of AF (HR 0.54, CI 0.34-0.86). 54 Overall, these data suggest that there may be a role for RAAS modulation in preventing AF and reducing its recurrence, but certainly more studies are needed.…”