title: Comparison of rate and rhythm control in hypertension patients with atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) is a very common cardiac arrhythmia, and is associated with an increased mortality in patients with hypertension. Whether the best therapeutic approach for these patients is to restore sinus rhythm (SR) or to adequately control the ventricular rate is still controversial. The aim of this study is to compare both strategies in patients with hypertension.
  
  
  RESULTS
  Two hundred and twenty-one patients with hypertension and AF of duration >48 h were randomly assigned to either the rhythm (n=155) or rate (n=66) control group. Exercise capacity was improved in the rhythm control group in the 1st year of the study (p<0.0001). There were no statistically significant differences in the embolic event rate and the total mortality between the 2 groups at the end of the study (p=NS).
  
  
  CONCLUSIONS
  Although restoring and maintaining SR had a beneficial effect on exercise capacity in patients with hypertension and AF, no significant difference was found in terms of the total mortality and the embolic event rates. Thus, rate control is an acceptable primary strategy in patients with AF and hypertension.
authors.affiliation: Department of Cardiology, Gazi Hospital, Izmir, Turkey. drayildiz@yahoo.com
authors.forename: Ahmet
authors.initials: A
authors.lastname: Yildiz
authors.forename: Zerrin
authors.initials: Z
authors.lastname: Yigit
authors.forename: Baris
authors.initials: B
authors.lastname: Okcun
authors.forename: Murat
authors.initials: M
authors.lastname: Baskurt
authors.forename: Kadriye
authors.initials: K
authors.lastname: Ortak
authors.forename: Aysem
authors.initials: A
authors.lastname: Kaya
authors.forename: Serdar
authors.initials: S
authors.lastname: Kucukoglu
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004077:Digoxin / Q000627:therapeutic use; D004554:Electric Countershock; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality; D019808:Losartan / Q000627:therapeutic use; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome; D014700:Verapamil / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D002316:Cardiotonic Agents; D004077:Digoxin; D014700:Verapamil; D008790:Metoprolol; D019808:Losartan