Randomized trial of angiotensin II-receptor blocker vs. dihydropiridine calcium channel blocker in the treatment of paroxysmal atrial fibrillation with hypertension (J-RHYTHM II Study)

Yamashita, Takeshi; Inoue, Hiroshi; Okumura, Ken; Kodama, Itsuo; Aizawa, Yoshifusa; Atarashi, Hirotsugu; Ohe, Tohru; Ohtsu, Hiroshi; Kato, Takao; Kamakura, Shiro; Kumagai, Koji; Kurachi, Yoshihisa; Koretsune, Yukihiro; Saikawa, Tetsunori; Sakurai, Minoru; Sato, Toshiaki; Sugi, Kaoru; Nakaya, Haruaki; Hirai, Makoto; Hirayama, Atsushi; Fukuda, Masahiko; Mitamura, Hideo; Yamazaki, Tsutomu; Watanabe, Eiichi; Ogawa, Satoshi; Investigators, J-Rhythm

doi:10.1093/europace/euq439

Cited by 102 publications

(84 citation statements)

References 32 publications

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“…Leczenie statyną nie zapobiega również AF w innych sytuacjach klinicznych [692,693]. Nie udało się także udowodnić przekonujących korzyści ze stosowania wielonienasyconych kwasów tłusz-czowych [241,[694][695][696][697][698]. Roli antagonistów aldosteronu w leczeniu AF nie oceniano dokładnie u ludzi.…”

Section: Antyarytmiczne Działanie Leków Nieantyarytmicznychunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,380

4,206

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Section: Antyarytmiczne Działanie Leków Nieantyarytmicznychunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,380

4,206

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“…In two retrospective analyses, ACEls and ARBs in addition to antiarrhythmic agents neither prevent progression to permanent AF 60 or AF recurrence. 61 Recently, the Japanese Rhythm Management Trial for Atrial Fibrillation (J-RHYTHM) II study 62 also demonstrated no reduction in the AF recurrence with candesartan as compared with amlodipine as monitored by daily transtelephonic ECG recording in 318 hypertensive patients with paroxysmal AF. Furthermore, the preliminary data of the prospective, randomized study------Angiotensin II Antagonist in Paroxysmal Atrial Fibrillation (ANTIPAF)------ 30,63 showed that olmesartan did not prevent AF in the absence of anitarrhythmic agents as compared with placebo.…”

Section: Raas Activationmentioning

confidence: 99%

Hypertension and atrial fibrillation: epidemiology, pathophysiology and therapeutic implications

Yiu

Siu

et al. 2011

J Hum Hypertens

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Hypertension is one of the most important risk factors associated with atrial fibrillation (AF) and increased the risk of cardiovascular events in patients with AF. However, the pathophysiological link between hypertension and AF is unclear. Nevertheless, this can be explained by the hemodynamic changes of the left atrium secondary to long standing hypertension, resulting in elevated left atrium pressure and subsequently left atrial enlargement. Moreover, the activation of renin --angiotensin --aldosterone system (RAAS) activation in patients with hypertension induces left atrial fibrosis and conduction block in the left atrium, resulting in the development of AF. Accordingly, recent studies have shown that effective blockage of RAAS by angiotensin converting enzyme inhibitors or angiotensin receptor antagonist may be effective in both primary and secondary prevention of AF in patients with hypertension, although with controversies. In addition, optimal antithrombotic therapy, blood pressure control as well as rate control for AF are key to the management of patients with AF. 1,2 Both hypertension 3 and AF 4 have increased frequency with the ageing population worldwide, and are associated with increased cardiovascular events. They are important risk factors for stroke, heart failure and overall mortality. 5 --7 On the other hand, hypertension is one of the important risk factors for the occurrence of AF, 8 and increased the risk of stroke and cardiovascular mortality in patients with AF.9,10 Compare with other risk factors for AF, hypertension appears to be responsible for more AF than any other risk factor because of its high prevalence. However, the pathophysiological link between AF and hypertension remains unclear. Moreover, it is also unclear whether treatment of hypertension prevents AF or reduces the risk of AF related complications. The purpose of this article is to review the epidemiology, underlying mechanisms and therapeutic implications of AF in hypertensive patients. A systematic literature search for full-text papers in the English language was performed using MEDLINE, Embase and the Cochrane library through to July 2011. In the search phrases used, the following terms were used: 'atrial fibrillation', 'hypertension', 'epidemiology', 'pathophysiology' and 'treatment'. Papers selected and cited in this review were based on the authors' view on the relevance to the manuscript. In addition, abstracts from international cardiovascular meetings were studied to identify unpublished studies.

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“…Valsartan also did not reduce the recurrent AF rate in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF) trial. 11 The J-RHYTHM II Study 12 in Japan also demonstrated that candesartan did not have a significant advantage over amlodipine in reducing recurrent AF. Patton and colleagues 13 reported that N-terminal probrain natriuretic peptide (NT-ProBNP) serves as a biomarker for AF recurrence regardless of the patients' race/ethnicity.…”

mentioning

confidence: 99%

Dose Timing of an Angiotensin II Receptor Blocker/Calcium Channel Blocker Combination in Hypertensive Patients With Paroxysmal Atrial Fibrillation

Kario

Uchiyama²,

Yoshida³

et al. 2016

J of Clinical Hypertension

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It has long been thought that there is a close association between hypertension and atrial fibrillation (AF). However, the efficacy of an angiotensin II receptor blocker for the prevention of organ damage in hypertensive individuals with AF is still controversial. The present study was a multicentered, prospective, randomized, open-label clinical trial investigating the differences in the effect of treatment with telmisartan/amlodipine combination tablets on blood pressure (BP) levels and BP variability between morning and bedtime administration in hypertensive patients with paroxysmal AF, using ambulatory BP monitoring (ABPM) and home BP. With this treatment, the patients' 24-hour BP, nighttime BP, preawake BP, and morning BP shown by ABPM were significantly reduced, and the antihypertensive effects were similar regardless of the timing of the drug administration. The standard deviation of day-by-day home systolic BP and the maximum home systolic BP were also significantly reduced, and these effects were similar regardless of the treatment timing. The N-terminal pro-brain natriuretic peptide level was significantly decreased only in the bedtime administration group. A larger study will demonstrate whether the bedtime administration of telmisartan/amlodipine combination tablets maximizes the risklowering effect against AF recurrence in paroxysmal AF hypertensive patients. J Clin Hypertens (Greenwich). 2016;18:1036-1044. ª 2016 Wiley Periodicals, Inc.A close association between hypertension and atrial fibrillation (AF) has long been suspected. The Framingham Heart Study 1 showed that hypertension was an independent risk factor for incident AF in a general population, and uncontrolled elevated blood pressure (BP) was associated with an increased risk of incident AF in patients treated for hypertension.2 Based on overseas clinical trials, the main etiology of AF is hypertension in approximately 60% of AF patients.3 In addition, the Suita Study, 4 a cohort study in Japan, showed that hypertension was associated with an increased risk of incident AF.It is also suspected that hypertension not only facilitates the onset and persistence of AF, but also raises the risk of a thromboembolism. Antihypertensive treatment is therefore considered essential for hypertensive individuals with AF to prevent recurrent AF, cerebral infarction, or heart failure. 5 In several countries, angiotensin II receptor blockers (ARBs) have attracted attention as a therapeutic drug for hypertensive individuals with AF.6-9 However, the Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events (ACTIVE I) 10 comparing the effect of irbesartan on patients with AF (mainly persistent and permanent types) with that of placebo showed no differences between irbesartan and placebo for the recurrence of AF, indicating that ARBs did not suppress the recurrence of AF. Valsartan also did not reduce the recurrent AF rate in the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico-Atrial Fibrillation (GISSI-AF...

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Randomized trial of angiotensin II-receptor blocker vs. dihydropiridine calcium channel blocker in the treatment of paroxysmal atrial fibrillation with hypertension (J-RHYTHM II Study)

Abstract: In patients with paroxysmal AF and hypertension, treatment of hypertension by candesartan did not have an advantage over amlodipine in the reduction in the frequency of paroxysmal AF (umin CTR C000000427).

Cited by 102 publications

References 32 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Hypertension and atrial fibrillation: epidemiology, pathophysiology and therapeutic implications

Dose Timing of an Angiotensin II Receptor Blocker/Calcium Channel Blocker Combination in Hypertensive Patients With Paroxysmal Atrial Fibrillation

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