Amlodipine and cardiovascular outcomes in hypertensive patients: meta-analysis comparing amlodipine-based versus other antihypertensive therapy.
10.3904/kjim.2014.29.3.315
- Author:
Seung Ah LEE
1
;
Hong Mi CHOI
;
Hye Jin PARK
;
Su Kyoung KO
;
Hae Young LEE
Author Information
1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. hylee612@snu.ac.kr
- Publication Type:Original Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't
- Keywords:
Amlodipine;
Calcium channel blockers;
Hypertension;
Meta-analysis
- MeSH:
Amlodipine/*therapeutic use;
Antihypertensive Agents/*therapeutic use;
Blood Pressure/*drug effects;
Calcium Channel Blockers/*therapeutic use;
Chi-Square Distribution;
Clinical Trials as Topic;
Heart Failure/etiology/mortality/*prevention & control;
Humans;
Hypertension/complications/diagnosis/*drug therapy/mortality/physiopathology;
Myocardial Infarction/etiology/mortality/*prevention & control;
Odds Ratio;
Risk Factors;
Stroke/etiology/mortality/*prevention & control;
Treatment Outcome
- From:The Korean Journal of Internal Medicine
2014;29(3):315-324
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: This meta-analysis compared the effects of amlodipine besylate, a charged dihydropyridine-type calcium channel blocker (CCB), with other non-CCB antihypertensive therapies regarding the cardiovascular outcome. METHODS: Data from seven long-term outcome trials comparing the cardiovascular outcomes of an amlodipine-based regimen with other active regimens were pooled and analyzed. RESULTS: The risk of myocardial infarction was significantly decreased with an amlodipine-based regimen compared with a non-CCB-based regimen (odds ratio [OR], 0.91; 95% confidence interval [CI], 0.84 to 0.99; p = 0.03). The risk of stroke was also significantly decreased (OR, 0.84; 95% CI, 0.79 to 0.90; p < 0.00001). The risk of heart failure increased slightly with marginal significance for an amlodipine-based regimen compared with a non-CCB-based regimen (OR, 1.14; 95% CI, 0.98 to 1.31; p = 0.08). However, when compared overall with beta-blockers and diuretics, amlodipine showed a comparable risk. Amlodipine-based regimens demonstrated a 10% risk reduction in overall cardiovascular events (OR, 0.90; 95% CI, 0.82 to 0.99; p = 0.02) and total mortality (OR, 0.95; 95% CI, 0.91 to 0.99; p = 0.01). CONCLUSIONS: Amlodipine reduced the risk of total cardiovascular events as well as all-cause mortality compared with non-CCB-based regimens, indicating its benefit for high-risk cardiac patients.
