Risk Alteration for Atrial Fibrillation with DifferentAntihypertensive Drugs.

A large percentage of patients with hypertension suffer from atrial fibrillation (AF). The concomitance of both conditions in the same patient markedly increases cardiovascular risk. Therefore, prevention of new-onset AF in hypertensive population should be a relevant target. High blood pressure promotes structural and electrophysiological changes in the heart that promote the develop- ment of AF. Thus, the most important therapeutic approach to prevent incident AF in hypertensive population is to reduce blood pressure values to recommended goals. However, in specific conditions, some antihypertensive agents may provide additional benefits beyond blood pressure reduction, such as in hypertension with left ven- tricular hypertrophy with renin angiotensin system blockade. On the other hand, in patients with hypertension and permanent AF, beta blockers and nondihydropiridine calcium antagonists (verapamil and diltiazem) play an important role. Antihypertensive agents may provide beneficial effects on incident AF, regardless of the presence of hyperten- sion. Thus, renin angiotensin system inhibitors may reduce new-onset AF in patients with heart failure or after the cardioversion of persistent AF. On the other hand, the preoperative administration of beta blockers may re- duce the incidence of postoperative AF in some patients. In this manuscript, the available evidence about the effects of different antihypertensive agents on new-onset AF in different populations is reviewed.