1.Amlodipine and cardiovascular outcomes in hypertensive patients: meta-analysis comparing amlodipine-based versus other antihypertensive therapy.
Seung Ah LEE ; Hong Mi CHOI ; Hye Jin PARK ; Su Kyoung KO ; Hae Young LEE
The Korean Journal of Internal Medicine 2014;29(3):315-324
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.
Amlodipine/*therapeutic use
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Antihypertensive Agents/*therapeutic use
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Blood Pressure/*drug effects
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Calcium Channel Blockers/*therapeutic use
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Chi-Square Distribution
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Clinical Trials as Topic
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Heart Failure/etiology/mortality/*prevention & control
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Humans
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Hypertension/complications/diagnosis/*drug therapy/mortality/physiopathology
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Myocardial Infarction/etiology/mortality/*prevention & control
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Odds Ratio
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Risk Factors
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Stroke/etiology/mortality/*prevention & control
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Treatment Outcome