Effect of Azilsartan on Atrial Fibrillation in Patients With Hypertension
Status:
Not yet recruiting
Trial end date:
2025-10-01
Target enrollment:
Participant gender:
Summary
Hypertension and atrial fibrillation (AF) are two major public health problems worldwide.
Hypertension is an important risk factor for AF, and the combination of which could
significantly increase the risk of cardiovascular adverse events, and result greater
disability rate and mortality.
Hypertension can stimulate cardiomyocytes apoptosis, drive renin-angiotensin-aldosterone
system (RAAS) activation, lead to left ventricular hypertrophy (LVH) and finally result in
the structure remodeling of the atrium, which can trigger AF development through influence on
myocardial electrical activity. Previous studies have found that angiotensin receptor
blockers (ARB) seem to be more efficient in preventing AF when hypertension combined heart
failure or LVH, but not completely clear in others with hypertension.
Azilsartan is a new ARB, it replaces the tetrazole ring of the traditional ARB with the
oxadiazole ring, which making it binds to the angiotensin type 1 (AT1) receptor more tightly,
dissociate more slowly, and has a stronger antihypertensive effect. It was reported that
Azilsartan could inhibit cell proliferation, reduce inflammation and oxidative stress.
However, whether Azilsartan can reduce the risk of AF in hypertensive patients, and the
possible corresponding mechanism is still unclear.
Accordingly, the investigators designed this study intending to evaluate the effect of
Azilsartan on the incidence of AF in hypertensive patients combined with LVH, and to explore
the possible mechanism. This study is a practical, multicenter randomized controlled research
method, the investigators will include 400 patients with hypertension and LVH who meet the
inclusion criteria in Beijing Tsinghua Changgung Hospital and other centers. The patients
would be divided into the Azilsartan group and conventional treatment group randomly, and be
followed up regularly for 12 months. The incidence of AF in the two groups would be compared
through the flexible intelligent ECG monitoring system, and the optimal blood pressure
control, also the left ventricular hypertrophy and left atrial function would be evaluated.
This study will provide evidence for the use of Azilsartan in blood pressure control and
lower risk for AF patients with hypertension and LVH. It will be benefit for improving
prognosis of patients with hypertension combined LVH, reducing the incidence of AF, and
achieving good social economic effects.