<![CDATA[Atrial remodeling, leading to atrial fibrillation (AF), is mediated by the reninâangiotensinâaldosterone system. Mild hypertensive outpatients (systolic/diastolic blood pressure 140â159/90â99 mmHg) in sinus rhythm who had experienced ⥠1 electrocardiogram (ECG)-documented AF episode in the previous six months received randomly Telmisartan 80 mg/day or carvedilol 25 mg/day. Blood pressure and 24-hour ECG were monitored monthly for one year; patients were asked to report symptomatic AF episodes and to undergo an ECG as early as possible. One hundred and thirty-two patients completed the study (Telmisartan, n=70; carvedilol, n=62). Significantly fewer AF episodes were reported with Telmisartan versus carvedilol (14.3% vs. 37.1%; p<0.003). Left atrial diameter, assessed by echocardiography, was similar with Telmisartan and carvedilol (3.4±2.3 cm vs. 3.6±2.4 cm). At study end, both regimes significantly reduced mean left ventricular mass index, but the reduction obtained with Telmisartan was significantly greater than with carvedilol (117.8±10.7 vs. 124.7±14.5; p<0.0001). Mean blood pressure values were not significantly different between the groups (Telmisartan 154/97 to 123/75 mmHg; p<0.001; carvedilol 153/94 to 125/78 mmHg; p<0.001). Telmisartan was significantly more effective than carvedilol in preventing recurrent AF episodes in hypertensive AF patients, despite a similar lowering of blood pressure]]>
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