Antihypertensive therapy in patients with paroxysmal form of atrial fibrillation: is drug selection important?
The study included 84 patients with paroxysmal atrial fibrillation (AF) and hypertension of different degrees. We evaluate the influence of antihypertensive therapy by calcium antagonists (CA) and inhibitors of angiotensin-converting enzyme (ACE) on the clinical course of paroxysmal AF in patients with hypertension and structural and functional remodeling of the myocardium. It was shown that the efficiency of blood pressure (BP) lowering by CA and ACE inhibitors is similar. BP control leads to significant decreasing of the frequency of AF paroxysm compared this using only “classic” ant arrhythmic drug. ACE inhibitors characterized by stable anti-relapsing activity, but protective effect CA decreased on 7,9% after 12 months. Compared with CA therapy by ACE inhibitors led to decreasing of structural and functional remodeling of the myocardium and reduction of AF paroxysm frequency on 61,5%, what can be caused by specific blockage of renin-angiotensin-aldosterone system.

Keywords: inhibitors of angiotensin-converting enzyme, calcium antagonists, myocardial remodeling, hypertension, atrial fibrillation