title: A multicentre, randomized study of telmisartan versus carvedilol for prevention of atrial fibrillation recurrence in hypertensive patients.
abstract: BACKGROUND
  Atrial remodelling, leading to atrial fibrillation (AF), is mediated by the renin-angiotensin-aldosterone system.
  
  
  METHODS
  Mild hypertensive outpatients (systolic/diastolic blood pressure 140-159/90-99 mmHg) in sinus rhythm who had experienced ≥ 1 electrocardiogram (ECG)-documented AF episode in the previous six months received randomly telmisartan 80 mg/day or carvedilol 25 mg/day. Blood pressure and 24-hour ECG were monitored monthly for one year; patients were asked to report symptomatic AF episodes and to undergo an ECG as early as possible.
  
  
  RESULTS
  One hundred and thirty-two patients completed the study (telmisartan, n=70; carvedilol, n=62). Significantly fewer AF episodes were reported with telmisartan versus carvedilol (14.3% vs. 37.1%; p<0.003). Left atrial diameter, assessed by echocardiography, was similar with telmisartan and carvedilol (3.4±2.3 cm vs. 3.6±2.4 cm). At study end, both regimes significantly reduced mean left ventricular mass index, but the reduction obtained with telmisartan was significantly greater than with carvedilol (117.8±10.7 vs. 124.7±14.5; p<0.0001). Mean blood pressure values were not significantly different between the groups (telmisartan 154/97 to 123/75 mmHg; p<0.001; carvedilol 153/94 to 125/78 mmHg; p<0.001).
  
  
  CONCLUSIONS
  Telmisartan was significantly more effective than carvedilol in preventing recurrent AF episodes in hypertensive AF patients, despite a similar lowering of blood pressure.
authors.affiliation: Division of Cardiology, San Gennaro Hospital, Naples, Italy. domenicogalzerano@libero.it
authors.forename: Domenico
authors.initials: D
authors.lastname: Galzerano
authors.forename: Sara
authors.initials: S
authors.lastname: Di Michele
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Paolisso
authors.forename: Bernardino
authors.initials: B
authors.lastname: Tuccillo
authors.forename: Diana
authors.initials: D
authors.lastname: Lama
authors.forename: Sabino
authors.initials: S
authors.lastname: Carbotta
authors.forename: Antonio
authors.initials: A
authors.lastname: Cittadini
authors.forename: Michele Adolfo
authors.initials: MA
authors.lastname: Tedesco
authors.forename: Carlo
authors.initials: C
authors.lastname: Gaudio
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D001562:Benzimidazoles / Q000494:pharmacology / Q000627:therapeutic use*; D001565:Benzoates / Q000494:pharmacology / Q000627:therapeutic use*; D002227:Carbazoles / Q000494:pharmacology / Q000627:therapeutic use*; D000077261:Carvedilol; D005260:Female; D006352:Heart Ventricles / Q000187:drug effects / Q000473:pathology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy* / Q000473:pathology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009929:Organ Size / Q000187:drug effects; D011412:Propanolamines / Q000494:pharmacology / Q000627:therapeutic use*; D012008:Recurrence; D000077333:Telmisartan
chemical_list: D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001565:Benzoates; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D000077333:Telmisartan