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J-RHYTHM II: BP-lowering therapy did not reduce patient days in AF
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Heart Rhythm Society 31st Annual Scientific Sessions
DENVER — Researchers for the J-RHYTHM II study reported that in patients with AF and hypertension, there were no differences in the occurrence of symptomatic or asymptomatic AF between patients treated with conventional antihypertensive therapy and those treated with a calcium antagonist.
They enrolled 318 patients with paroxysmal AF and hypertension and randomly assigned them to either candesartan 8-to-12 mg daily (Atacand, AstraZeneca; n=158) or amlodipine 2.5-to-5 mg daily (Norvasc, Pfizer; n=160). Patients were followed using daily transtelephonic monitoring. The primary study endpoint was the difference in the number of days per month the patient had AF between baseline and one-month follow-up. Secondary endpoints included development rate into persistent AF, left atrial dimension and changes in quality of life.
According to the results, the frequency of paroxysmal AF per month was 3.8 ± 5.0 days in the candesartan group and 4.8 ± 6.3 days in the amlodipine group, which was not statistically significant. At study completion, there was no difference in the total number of days in AF between the two study groups (P=.133). There were also no differences in symptomatic episodes with or without AF (P=.804).
Patients in the candesartan group had increased BP compared with the amlodipine group (P<.001), and days per month in AF gradually decreased in both treatment arms. Persistent AF development rates tended to be lower in the candesartan group vs. the amlodipine group (8% vs. 14%), but the difference was not statistically significance.
“BP was further decreased by amlodipine than by candesartan, and there were no differences in symptomatic or asymptomatic AF days per month in the study patients,” Takeshi Yamashita, MD, PhD, of The Cardiovascular Institute in Tokyo, said. “There was also no difference in development of AF into persistent AF, and no difference in quality of life. However, BP control by both candesartan and amlodipine did decrease the number of paroxysmal AF episodes.” – by Eric Raible
For more information:
- Yamashita T. LBCT II. Presented at: Heart Rhythm Society 31st Annual Scientific Sessions; May 12-15, 2010; Denver.
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