Effect of High-dose Telmisartan on the Prevention of Recurrent Atrial Fibrillation in Hypertensive Patients.

Background: Telmisartan has been shown to exert an equivalent action as ramipril on the prevention of cardiovascular events, but the dose-dependent actions of telmisartan on the prevention of events remain unknown. Objective: We investigated the dose-dependent effects of telmisartan on the prevention of AF in patients associated with risk factors. Methods: One hundred hypertensive patients were randomized to take 40 mg (low-dose group: n=57) or 80 mg (high-dose group: n=43) of telmisartan for 24 months. The primary endpoints were defined as a new development and/or recurrence of atrial fibrillation (AF). Results: The mean values of the blood pressure in both groups decreased significantly and to similar degrees after 24 months, in the low-dose (p < 0.01) and high-dose (p < 0.01) groups. At the end of the follow-up, the incidence of AF was lower in the high-dose group than in the low-dose group (p < 0.05). Moreover, the proportion of AF recurrences in the patients with a past history of paroxysmal AF was lower in the high-dose group than in the low-dose group (p < 0.05). Further, using a logistic regression model, there were no risk factors associated with the incidence of AF. Conclusion: The results indicated that telmisartan in low doses was as effective in controlling the blood pressure as in high doses, but high doses of telmisartan had beneficial effects on preventing the recurrence of AF in hypertensive patients.