Statins and new-onset atrial fibrillation in a cohort of patients with hypertension. Analysis of electronic health records, 2006-2015

PLoS One. 2017 Oct 26;12(10):e0186972. doi: 10.1371/journal.pone.0186972. eCollection 2017.

Abstract

Hypertension is the most prevalent risk factor for new-onset atrial fibrillation (AF). But few studies have addressed the effect of statins on the incidence of this arrhythmia in patients with hypertension. This study aimed to evaluate the effect of statins on new-onset of this arrhythmia in a hypertensive population, accounting for AF risk. Data from the Information System for the Development of Research in Primary Care was used to recruit a retrospective cohort of ≥55-year-old hypertensive individuals with no ischemic vascular disease, in 2006-2007, followed up through 2015. The effect of initiating statin treatment on new-onset atrial fibrillation was assessed with Cox proportional hazards models adjusted by the propensity score of receiving statin treatment, in the overall study population and stratified by AF risk. Of 100 276 included participants, 9814 initiated statin treatment. The AF incidence per 1000 person-years (95% confidence interval) was 12.5 (12.3-12.8). Statin use associated with a significant (9%) reduction in AF incidence. Differences in absolute AF incidence were higher in the highest AF risk subgroup, and the estimated number needed to treat to avoid one case was 720. The relative effect was poor, similar across groups, and non-significant, as was the association of statins with adverse effects. We found a limited protective effect of statins over new-onset AF in this hypertensive population with no ischemic vascular disease. If there is no further indication, hypertensive patients would not benefit from statin use solely for AF primary prevention.

MeSH terms

  • Aged
  • Atrial Fibrillation / complications*
  • Atrial Fibrillation / drug therapy*
  • Electronic Health Records*
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypertension / complications*
  • Male
  • Retrospective Studies
  • Risk

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors

Grants and funding

Lia Alves-Cabratosa was supported by a Ph.D. grant from Institut d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol) and Primary Care Services (4R14/026). This project was also supported by clinical research grants from Carlos III Health Institute, within the Net for Research in Preventive Activities and Health Enhancement (RedIAPP RD16/0007/0004) framework; the Spanish Ministry of Health(EC10-84); and the Agency for Management of University and Research Grants (2014 SGR 902).