Upstream therapeutic strategies of valsartan and fluvastatin on hypertensive patients with non‐permanent atrial fibrillation

Abstract

Summary Aim To investigate the upstream therapeutic effects of fluvastatin and valsartan on hypertensive patients with non‐permanent atrial fibrillation (AF). Methods A total of 189 patients who were admitted to outpatient and inpatient department from eight medical centers in China, diagnosed as hypertension with non‐permanent AF, were divided into four groups randomly: the CCBs group (group A, n = 45); CCB + fluvastatin group (group B, n = 48); valsartan group (group C, n = 46); valsartan + fluvastatin group (group D, n = 50). The four groups were followed up for 24 months. The blood routine, biochemical examination, echocardiography, high sensitive C‐reactive protein (hs‐CRP), N‐terminal pro‐brain natriuretic peptide (NT‐proBNP), the maintenance rate of sinus rhythm, and the recurrence of paroxysmal AF or persistent AF incidence were observed in these groups before and after 24 months' treatment. Results After 24 months of follow‐up, there were 178 cases of patients who have completed the study. (a) There was no significant difference in blood routine, liver, and renal function in each group (P > 0.05). (b) The blood lipids level in groups B and D was significantly reduced after treatment (P < 0.01). There was no significant difference of hs‐CRP level in group A (P > 0.05). The left ventricular remodeling was significantly alleviated in group C and group D (P < 0.05). The NT‐ProBNP level was significantly decreased in group D (P < 0.05). (c) The sinus rhythm maintenance rate of group B, group C, and group D was higher than group A (77.78%, 70.45%, 79.17% vs 43.90%), the occurrence of persistent AF was significantly lower than group A (11.11%, 14.29%, 8.33% vs 31.71%; P < 0.05). Conclusions CCB plus fluvastatin and valsartan can reduce the recurrence rate of non‐permanent AF and to delay the progression from non‐permanent AF to permanent AF in patients with hypertension. The combined application of valsartan and fluvastatin is more effective than valsartan or CCB alone in the upstream therapies of AF.

Angiotensin Receptor Blocker and Calcium Channel Blocker Preventing Atrial Fibrillation Recurrence in Patients with Hypertension and Atrial Fibrillation: A Meta-analysis

“…The follow-up of included studies ranged from 0.5 to 2 years; the median was 1 year. As to ARB category, patients of two studies were prescribed with telmisartan [8,10], two studies with valsartan [11,17], one study with losartan [18], one with irbesartan [19], and one with candesartan [20]. As to CCB category, patients of six studies were prescribed with amlodipine, [10,11,[17][18][19][20] and one with nifedipine [8].…”

“…As to ARB category, patients of two studies were prescribed with telmisartan [8,10], two studies with valsartan [11,17], one study with losartan [18], one with irbesartan [19], and one with candesartan [20]. As to CCB category, patients of six studies were prescribed with amlodipine, [10,11,[17][18][19][20] and one with nifedipine [8]. Two studies were conducted in China [8,17], two in Japan [19,20], and three in Italy [10,11,18].…”

“…As to CCB category, patients of six studies were prescribed with amlodipine, [10,11,[17][18][19][20] and one with nifedipine [8]. Two studies were conducted in China [8,17], two in Japan [19,20], and three in Italy [10,11,18].…”

“…Persistent AF. A total of 7 trials enrolling 1495 patients were included in this study [8,10,11,[17][18][19][20]. 744 patients were prescribed with ARB and 751 with CCB.…”

Combined treatment with valsartan and fluvastatin to delay disease progression in nonpermanent atrial fibrillation with hypertension: A clinical trial

“…29 Our previous study has also shown that fluvastatin is beneficial for maintaining normal sinus rhythm in patients with nonpermanent AF. 30 Furthermore, Inohara et al 31 suggested that the progression and recurrence of AF are closely related to BNP level. In this study, we showed that compared with using valsartan alone, the combination of valsartan and fluvastatin can improve the heart structure as a significant decrease in NT-proBNP (P < .05).…”