Abstract 4100: Atorvastatin Addition to Losartan or to Atenolol and Recurrence of Paroxysmal Atrial Fibrillation in Hypertension
Aim of the study was to compare the effect of atorvastatin addition to losartan and to atenolol on prevention of atrial fibrillation (AF) recurrence in normocholesterolemic hypertensive patients with recent paroxysmal AF. Three hundred and twenty six normocholesterolemic mild hypertensive (SBP > 140 < 160 mmHg and/or DBP > 90 < 100 mmHg) out-patients in sinus rhythm, but with at least 2 ECG-documented episodes of AF in the previous 6 months, were randomised to losartan 100mg od plus atorvastatin 20mg od (n=83) or plus placebo (n=81) or to atenolol 100mg od plus atorvastatin 20mg od (n=82) or plus placebo (n=80) and were followed up for 1 year. Clinic BP and ECG were evaluated every month; the patients were asked to report any episode of symptomatic AF and to perform an ECG as early as possible. SBP/DBP values were significantly reduced both by losartan and atenol (p<0.001 both for SBP and DBP) without any difference between the two regimens. At least one ECG documented episode of AF was reported in 29 (36.2%) patients treated with atenolol plus placebo, and in 14 (17.2%) patients treated with losartan plus placebo, with a significant difference between treatments (p<0.01). Atorvastatin addition reduced the recurrence of AF episodes in the atenolol group (from 36.2% to 24.3%, p< 0.05), but not in the losartan group (from 17.2% to 15.6%, ns). Despite similar BP reduction, losartan was more effective than atenolol in preventing new episodes of AF in normocholesterolemic hypertensive patients. The addition of atorvastatin was associated with a significant reduction of recurrent AF only in patients taking atenolol. This suggests that the great effect of prevention of AT1 receptor blockers could eclipse the potential positive effect of statins.