Title:Beta-blockers in Hypertensive Left Ventricular Hypertrophy and Atrial
Fibrillation Prevention
Volume: 22
Issue: 1
Author(s): Goran Koraćević, Sladjana Mićić, Milovan Stojanović*, Marija Zdravkovic, Dragan Simić, Tomislav Kostić, Vesna Atanasković and Ružica Janković-Tomašević
Affiliation:
- Institute for Treatment and Rehabilitation
Niška Banja, Niš, Serbia
Keywords:
Atrial fibrillation, beta-blockers, heart failure, sudden cardiac death, left ventricular hypertrophy, hypertensive.
Abstract:
Background: Hypertensive left ventricular hypertrophy (HTN LVH) is a key risk factor
for atrial fibrillation (AF).
Objective: To evaluate the possible role of beta-blockers (BBs) in addition to a renin-angiotensinaldosterone
system (RAAS) blocker in AF prevention in patients with HTN LVH.
Methods: We performed a PubMed, Elsevier, SAGE, Oxford, and Google Scholar search with the
search items ‘beta blocker hypertension left ventricular hypertrophy patient’ from 2013-2023. In the
end, a ‘snowball search’, based on the references of relevant papers as well as from papers that cited
them was performed.
Results: HTN LVH is a risk factor for AF. In turn, AF substantially complicates HTN LVH and contributes
to the genesis of heart failure (HF) with preserved ejection fraction (HFpEF). The prognosis
of HFpEF is comparable with that of HF with reduced EF (HFrEF), and, regardless of the type, HF is
associated with five-year mortality of 50-75%. The antiarrhythmic properties of BBs are wellrecognized,
and BBs as a class of drugs are - in general - recommended to decrease the incidence of
AF in HTN.
Conclusion: BBs are recommended (as a class) for AF prevention in several contemporary guidelines
for HTN. LVH regression in HTN - used as a single criterion for the choice of antihypertensive medication
- does not capture this protective effect. Consequently, it is worth studying how meaningful
this antiarrhythmic action (to prevent AF) of BBs is in patients with HTN LVH in addition to a
RAAS blocker.
