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Beta-blockers in Hypertensive Left Ventricular Hypertrophy and Atrial Fibrillation Prevention

Goran Koraćević1,2, Sladjana Mićić3, Milovan Stojanović4

  • 1Department of Cardiovascular Diseases, University Clinical Center Niš, Serbia.

Current Vascular Pharmacology
|November 30, 2023
PubMed

Insights

Beta-blockers (BBs) may help prevent atrial fibrillation (AF) in patients with hypertensive left ventricular hypertrophy (HTN LVH). Further study is needed to confirm their antiarrhythmic role alongside renin-angiotensin-aldosterone system (RAAS) blockers.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Hypertensive left ventricular hypertrophy (HTN LVH) is a significant risk factor for developing atrial fibrillation (AF).
  • Atrial fibrillation complicates HTN LVH, contributing to heart failure with preserved ejection fraction (HFpEF), which carries a high mortality rate.

Purpose of the Study:

  • To evaluate the potential benefit of beta-blockers (BBs) in preventing AF.
  • To assess the role of BBs when used in conjunction with renin-angiotensin-aldosterone system (RAAS) blockers for AF prevention in patients with HTN LVH.

Main Methods:

  • A comprehensive literature search was conducted across PubMed, Elsevier, SAGE, Oxford, and Google Scholar databases.
  • Searches focused on studies published between 2013 and 2023 using keywords related to beta-blockers, hypertension, and left ventricular hypertrophy.
  • A snowball search strategy was employed, reviewing references of relevant papers and their citing articles.

Main Results:

  • Hypertensive left ventricular hypertrophy (HTN LVH) is established as a risk factor for atrial fibrillation (AF).
  • Beta-blockers (BBs) are recognized for their antiarrhythmic properties and are generally recommended to reduce AF incidence in hypertension.
  • Current guidelines recommend BBs for AF prevention in hypertension, but their specific antiarrhythmic effect in HTN LVH patients on RAAS blockers requires further investigation.

Conclusions:

  • Beta-blockers (BBs) are recommended for atrial fibrillation (AF) prevention in hypertension (HTN).
  • The regression of left ventricular hypertrophy (LVH) alone does not fully represent the protective effect of antihypertensive medications against AF.
  • The antiarrhythmic efficacy of BBs in patients with HTN LVH, particularly when combined with a RAAS blocker, warrants further investigation.
Abstract

Keywords:
Atrial fibrillationbeta-blockersheart failurehypertensive.left ventricular hypertrophysudden cardiac death

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