Uso de diuréticos y fibrilación auricular

Una de las complicaciones que más tememos en Medicina es el desarrollo de Fibrilación auricular (FA), ya que además del riesgo de tromboembolísmo que esta implica, tenemos que usar anticoagulantes permanentemenete, con el riesgo de hemorragia y si consideramos que esta entidad se dá más frecuentemente en adultos mayores  (AM), es muy importante tomar todas las medidas no farmacológicas para evitar la FA.   Por otro lado un porcentaje alto de AM, tiene hipertensión arterial y por ello tenemos que usar medicamentos antihipertensivos, por lo que les invito a leer este interesante artículo publicado en MD Linx este mes.

Long-term effect of antihypertensive drugs on the risk of new-onset atrial fibrillation: A longitudinal cohort study
Hypertension Research, 07/15/14

Jong GP, et al. – The results of this study suggest that hypertensive patients who take diuretics have a significant increase in the risk of NAF, whereas patients who take ACE inhibitors are at lower risk of NAF. Methods The authors report a population–based study in which they investigated the relationship between antihypertensive drug therapy and the risk of NAF. The population sample consisted of 47682 hypertensive patients identified from claim forms provided to the central regional branch of the Bureau of National Health Insurance in Taiwan between January 2005 and December 2010. Prescriptions for antihypertensive drugs prescribed before the index date were retrieved from a prescription database. From these data, they estimated the hazard ratio (HR) of NAF associated with antihypertensive drug use; non–NAF subjects served as the reference group. Results After adjusting for age and sex, they observed that the risk of NAF was higher among the patients taking diuretics (HR, 1.39; 95% confidence interval (CI), 1.06–1.82) compared with the patients not taking diuretics. Patients who took angiotensin–converting enzyme (ACE) inhibitors (HR, 0.79; 95% CI, 0.65–0.97) showed a lower risk of developing NAF compared with the nonusers of ACE inhibitors. Angiotensin receptor blockers, alpha–blockers, beta–blockers and calcium channel blockers were not associated with a risk of NAF.