{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T16:44:19Z","timestamp":1768322659818,"version":"3.49.0"},"reference-count":40,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>\u03b2-blockers have been widely used in patients with extensive cardiovascular disease (CVD) and have provided benefits. However, they are more likely to cause symptomatic bradycardia, hypotension, or glucose metabolism disorders, which may lead to an increased risk of atrial fibrillation (AF), but evidence is lacking.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study was to analyze the association between the use of \u03b2-blockers and the risk of developing AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This nationwide, prospective cohort study utilized data from the 2013\u20132020 National Health and Nutrition Examination Survey (NHANES). The patients were stratified into a \u03b2-blocker treatment group (<jats:italic>n<\/jats:italic> = 2585) and a non-\u03b2-blocker treatment group (<jats:italic>n<\/jats:italic> = 8525). Univariate and multivariate logistic regression analyses were performed to identify the relationship between \u03b2-blockades and the risk of AF. Propensity matching analysis was used to balance patient baseline characteristics and to control for confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 11,110 subjects were included in this study (mean [SD] age, 59.89 [15.07] years; 5657 [49.7%] males). A total of 111\/2585 subjects developed AF in the \u03b2-blocker treatment group, and 75\/8525 developed AF in the non-\u03b2-blocker treatment group (incidence rate, 4.2% vs. 0.8%). Compared with the non-\u03b2-blocker group, the \u03b2-blocker group had an increased risk of incident AF (aOR, 2.339; 95% CI, 1.614\u20133.410). Some sensitivity analyses also revealed consistent findings of increased AF risk associated with \u03b2-blocker treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The findings from this study suggest that \u03b2-blocker treatment is associated with an increased risk of incident AF and may help physicians select a modest medication for patients while also assessing the risk of AF.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2024.1418465","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T11:55:30Z","timestamp":1719316530000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["\u03b2-blockades and the risk of atrial fibrillation in patients with cardiovascular diseases"],"prefix":"10.3389","volume":"15","author":[{"given":"Xun-Hu","family":"Gu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weichao","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heng","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xun","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiang","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuyan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianping","family":"Gong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yizhou","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,25]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"893","DOI":"10.1016\/j.jchf.2023.03.017","article-title":"Beta-blocker use and heart failure outcomes in mildly reduced and preserved ejection fraction","volume":"11","author":"Arnold","year":"2023","journal-title":"JACC Heart Fail"},{"key":"B2","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1007\/s10840-012-9722-1","article-title":"Atrial conduction time and atrial mechanical function in patients with impaired fasting glucose","volume":"35","author":"Ayhan","year":"2012","journal-title":"J. Interv. Card. Electrophysiol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2227","DOI":"10.1001\/jama.292.18.2227","article-title":"Metabolic effects of carvedilol vs metoprolol in patients with type 2 diabetes mellitus and hypertension: a randomized controlled trial","volume":"292","author":"Bakris","year":"2004","journal-title":"JAMA"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1254","DOI":"10.1016\/j.amjcard.2007.05.057","article-title":"A meta-analysis of 94,492 patients with hypertension treated with beta blockers to determine the risk of new-onset diabetes mellitus","volume":"100","author":"Bangalore","year":"2007","journal-title":"Am. J. Cardiol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"e1001885","DOI":"10.1371\/journal.pmed.1001885","article-title":"The REporting of studies Conducted using Observational Routinely-collected health Data (RECORD) statement","volume":"12","author":"Benchimol","year":"2015","journal-title":"PLoS Med."},{"key":"B6","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.1016\/j.jacc.2022.03.337","article-title":"The increasing role of rhythm control in patients with atrial fibrillation: JACC state-of-the-art review","volume":"79","author":"Camm","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"2379","DOI":"10.1016\/j.jacc.2019.08.1047","article-title":"Sex-related differences in heart failure after ST-segment elevation myocardial infarction","volume":"74","author":"Cenko","year":"2019","journal-title":"J. Am. Coll. Cardiol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1615","DOI":"10.1016\/j.amjcard.2010.07.038","article-title":"Atrial substrate properties and outcome of catheter ablation in patients with paroxysmal atrial fibrillation associated with diabetes mellitus or impaired fasting glucose","volume":"106","author":"Chao","year":"2010","journal-title":"Am. J. Cardiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1093\/eurheartj\/ehx564","article-title":"Beta-blockers for heart failure with reduced, mid-range, and preserved ejection fraction: an individual patient-level analysis of double-blind randomized trials","volume":"39","author":"Cleland","year":"2018","journal-title":"Eur. Heart J."},{"key":"B10","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1136\/hrt.37.4.357","article-title":"Effect of propranolol on left ventricular function, segmental wall motion, and diastolic pressure-volume relation in man","volume":"37","author":"Coltart","year":"1975","journal-title":"Br. Heart J."},{"key":"B11","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1161\/HYPERTENSIONAHA.109.139592","article-title":"Impact of abdominal obesity on incidence of adverse metabolic effects associated with antihypertensive medications","volume":"55","author":"Cooper-DeHoff","year":"2010","journal-title":"Hypertension"},{"key":"B12","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1016\/S0140-6736(02)08089-3","article-title":"Cardiovascular morbidity and mortality in the Losartan Intervention for Endpoint reduction in hypertension study (LIFE): a randomised trial against atenolol","volume":"359","author":"Dahl\u00f6f","year":"2002","journal-title":"Lancet"},{"key":"B13","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1016\/j.jjcc.2015.06.003","article-title":"Assessment of atrial electromechanical delay and P-wave dispersion in patients with type 2 diabetes mellitus","volume":"67","author":"Demir","year":"2016","journal-title":"J. Cardiol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"l5657","DOI":"10.1136\/bmj.l5657","article-title":"Alternative approaches for confounding adjustment in observational studies using weighting based on the propensity score: a primer for practitioners","volume":"367","author":"Desai","year":"2019","journal-title":"BMJ"},{"key":"B15","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/S0140-6736(07)60108-1","article-title":"Incident diabetes in clinical trials of antihypertensive drugs: a network meta-analysis","volume":"369","author":"Elliott","year":"2007","journal-title":"Lancet"},{"key":"B16","doi-asserted-by":"publisher","first-page":"S19","DOI":"10.2337\/dc23-S002","article-title":"2. Classification and diagnosis of diabetes: standards of care in diabetes-2023","volume":"46","author":"ElSayed","year":"2023","journal-title":"Diabetes Care"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2486","DOI":"10.1001\/jama.285.19.2486","article-title":"Executive summary of the third report of the national cholesterol education program (NCEP) expert Panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment Panel III)","volume":"285","year":"2001","journal-title":"JAMA"},{"key":"B18","doi-asserted-by":"publisher","first-page":"59","DOI":"10.5603\/CJ.2013.0010","article-title":"Impaired atrial electromechanical function and atrial fibrillation promotion in alloxan-induced diabetic rabbits","volume":"20","author":"Fu","year":"2013","journal-title":"Cardiol. J."},{"key":"B19","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1136\/heartjnl-2020-317735","article-title":"Prognostic significance of natriuretic peptide levels in atrial fibrillation without heart failure","volume":"107","author":"Hamatani","year":"2021","journal-title":"Heart"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1759","DOI":"10.1136\/heartjnl-2023-322635","article-title":"Rate control in atrial fibrillation, calcium channel blockers versus beta-blockers","volume":"109","author":"Koldenhof","year":"2023","journal-title":"Heart"},{"key":"B21","doi-asserted-by":"publisher","first-page":"2497","DOI":"10.1001\/jama.2020.23138","article-title":"Effect of digoxin vs bisoprolol for heart rate control in atrial fibrillation on patient-reported quality of life: the RATE-AF randomized clinical trial","volume":"324","author":"Kotecha","year":"2020","journal-title":"JAMA"},{"key":"B22","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1038\/nrendo.2012.21","article-title":"Cardiovascular autonomic neuropathies as complications of diabetes mellitus","volume":"8","author":"Kuehl","year":"2012","journal-title":"Nat. Rev. Endocrinol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"203","DOI":"10.2337\/diacare.14.3.203","article-title":"Effect of antihypertensive drugs on insulin, glucose, and lipid metabolism","volume":"14","author":"Lithell","year":"1991","journal-title":"Diabetes Care"},{"key":"B24","doi-asserted-by":"publisher","first-page":"260","DOI":"10.1093\/europace\/euad010","article-title":"Beta-blockers in atrial fibrillation-trying to make sense of unsettling results","volume":"25","author":"Meyer","year":"2023","journal-title":"Europace"},{"key":"B25","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1161\/CIRCRESAHA.120.316363","article-title":"Molecular basis of atrial fibrillation pathophysiology and therapy: a translational perspective","volume":"127","author":"Nattel","year":"2020","journal-title":"Circ. Res."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1693","DOI":"10.1161\/CIRCULATIONAHA.121.057095","article-title":"Randomized ablation-based rhythm-control versus rate-control trial in patients with heart failure and atrial fibrillation: results from the RAFT-AF trial","volume":"145","author":"Parkash","year":"2022","journal-title":"Circulation"},{"key":"B27","article-title":"Reducing bias in a propensity score matched-pair sample using greedy matching techniques","volume-title":"Proceedings of the twenty-sixth annual SAS users group international conference","year":"2001"},{"key":"B28","doi-asserted-by":"publisher","first-page":"606","DOI":"10.1136\/heartjnl-2022-321633","article-title":"Dysregulated carbohydrate and lipid metabolism and risk of atrial fibrillation in advanced old age","volume":"109","author":"Pellegrini","year":"2023","journal-title":"Heart"},{"key":"B29","doi-asserted-by":"publisher","first-page":"2135","DOI":"10.1016\/j.jacc.2003.09.022","article-title":"A better survival for women with heart failure? It's not so simple","volume":"42","author":"Pina","year":"2003","journal-title":"J. Am. Coll. Cardiol."},{"key":"B30","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1016\/j.jchf.2012.09.002","article-title":"Beta-blockers and outcome in heart failure and atrial fibrillation: a meta-analysis","volume":"1","author":"Rienstra","year":"2013","journal-title":"JACC Heart Fail"},{"key":"B31","doi-asserted-by":"publisher","first-page":"m441","DOI":"10.1136\/bmj.m441","article-title":"Calculating the sample size required for developing a clinical prediction model","volume":"368","author":"Riley","year":"2020","journal-title":"BMJ"},{"key":"B32","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1016\/j.ahj.2019.09.013","article-title":"Associations between \u03b2-blocker therapy and cardiovascular outcomes in patients with diabetes and established cardiovascular disease","volume":"218","author":"Shavadia","year":"2019","journal-title":"Am. Heart J."},{"key":"B33","doi-asserted-by":"publisher","first-page":"e1916598","DOI":"10.1001\/jamanetworkopen.2019.16598","article-title":"Association of \u03b2-blocker use with heart failure hospitalizations and cardiovascular disease mortality among patients with heart failure with a preserved ejection fraction: a secondary analysis of the topcat trial","volume":"2","author":"Silverman","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"B34","doi-asserted-by":"publisher","first-page":"796","DOI":"10.4065\/81.6.796","article-title":"Effect of antihypertensive agents on the development of type 2 diabetes mellitus","volume":"81","author":"Stump","year":"2006","journal-title":"Mayo Clin. Proc."},{"key":"B35","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1161\/HYPERTENSIONAHA.117.09259","article-title":"Risk of cardiovascular events in patients with diabetes mellitus on \u03b2-blockers","volume":"70","author":"Tsujimoto","year":"2017","journal-title":"Hypertension"},{"key":"B36","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1093\/eurheartj\/eht429","article-title":"Calcium channel blockers improve exercise capacity and reduce N-terminal Pro-B-type natriuretic peptide levels compared with beta-blockers in patients with permanent atrial fibrillation","volume":"35","author":"Ulimoen","year":"2014","journal-title":"Eur. Heart J."},{"key":"B37","doi-asserted-by":"publisher","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"335","author":"von Elm","year":"2007","journal-title":"BMJ"},{"key":"B38","doi-asserted-by":"publisher","first-page":"e127","DOI":"10.1016\/j.jacc.2017.11.006","article-title":"2017 ACC\/AHA\/AAPA\/ABC\/ACPM\/AGS\/APhA\/ASH\/ASPC\/NMA\/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of cardiology\/American heart association task force on clinical practice guidelines","volume":"71","author":"Whelton","year":"2017","journal-title":"J. Am. Coll. Cardiol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"1213","DOI":"10.1161\/CIRCULATIONAHA.105.595496","article-title":"Differential impact of blood pressure-lowering drugs on central aortic pressure and clinical outcomes: principal results of the Conduit Artery Function Evaluation (CAFE) study","volume":"113","author":"Williams","year":"2006","journal-title":"Circulation"},{"key":"B40","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1016\/S0140-6736(04)17018-9","article-title":"Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study","volume":"364","author":"Yusuf","year":"2004","journal-title":"Lancet"}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2024.1418465\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T11:55:36Z","timestamp":1719316536000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2024.1418465\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,25]]},"references-count":40,"alternative-id":["10.3389\/fphar.2024.1418465"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2024.1418465","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,25]]},"article-number":"1418465"}}