Abstract 2997: Statins Therapy and Atrial Fibrillation in Hypertensive Patients
Introduction: Statin use is demonstrated to be protective against atrial fibrillation (AF) after coronary artery bypass grafting. Since population risk of AF attributable to arterial hypertension is greater than with any other risk factor, we determined incidence of AF or flutter (AFlu) in hypertensive subjects under antihypertensive treatment.
Hypothesis: evaluate the effects of statin on the top of antihypertensive terapy to prevent arrhythmia.
Methods: This is an observational, open-label, prospective study, involving hypertensive patients (JNCVII) with optimal blood pressure (BP) control, analyzed based on the following criteria: caucasian ethnicity, absence of secondary hypertension, obesity and prevalent cardiovascular disease. Participants were examined every 6 months over a 3.5 ± 3.3 year follow-up. AF or AFlu were adjudicated by one of the folowing: ECG at each examination, self-reported AF or AFlu at annual examination, or diagnosis at hospital discharge. Complete follow-up data were obtained in 2304 patients (1126 taking statins and 1178 without statins in therapy).
Results: AF or AFlu occurred in 44 patients (30 in the control group and 14 in the Statin group; p = 0.01). Age and sex-adjusted hazard of AF-AFlu was significantly lower in patients taking statins (HR = 0.46, 0.24 – 0.86, p = 0.02). Addition of antihypertensive treatment with ACE-inhibitors or ARBs, baseline BP, HDL and LDL cholesterol and triglycerides as covariates resulted in an improved statin protection (HR = 0.18, 0.08 – 0.41, p < 0.0001).
Conclusions: Addition of statins on the top of optimized antihypertensive therapy protects against AF/AFlu independently of effects on BP and lipid profile.