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Therapeutic Advances in Cardiovascular Disease
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*Atrial Fibrillation
*Stroke
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Article

The left atrium, atrial fibrillation, and the risk of stroke in hypertensive patients with left ventricular hypertrophy

Kristian Wachtell1, Richard B. Devereux2, Paulette A. Lyle3*, Peter M. Okin2, and Eva Gerdts4

1 The Heart Center, Rigshospitalet, Copenhagen, Denmark
2 Weill Cornell Medical College, New York, NY
3 Merck Research Laboratories, North Wales, PA
4 Institute of Medicine, University of Bergen and Department of Heart Disease, Haukeland University Hospital, Bergen, Norway

* To whom correspondence should be addressed.


  Abstract

The Losartan Intervention For Endpoint reduction in hypertension (LIFE) study provided extensive data on predisposing factors, consequences, and prevention of atrial fibrillation (AF) in patients with hypertension and left ventricular (LV) hypertrophy. Randomized losartan-based treatment was superior to atenolol-based treatment for reducing new-onset AF and complications, especially stroke, associated with new-onset or pre-existing AF. Potential mechanisms of AF prevention by angiotensin receptor blockade supported by LIFE results include greater reduction in left atrial size and LV hypertrophy. Differential effects of antihypertensive treatment on the left atrium and left ventricle may help prevent AF and reduce risk of stroke associated with hypertensive heart disease.

Key Words: atrial fibrillation, left atrial function, left atrial size, outcomes

First published on August 21, 2008, doi:10.1177/1753944708093846

Therapeutic Advances in Cardiovascular Disease 2008;2:507.

A more recent version of this article appeared on December 1, 2008

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