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Emerging data on calcium-channel blockers: the COHORT study
1Centro Fisiologia Clinica e Ipertensione, Universita di Milano, Ospedale Maggiore e Istituto Auxologico Italiano, Milan, Italy. zanchett@mailserver.unimi.it
Clinical Cardiology
|March 8, 2003
Summary
Newer dihydropyridine calcium-channel blockers (CCBs) like lercanidipine and lacidipine show better tolerability than amlodipine in elderly hypertensive patients. This improved tolerability may enhance patient compliance and blood pressure management.
Area of Science:
- Cardiology
- Pharmacology
- Geriatrics
Background:
- Dihydropyridine calcium-channel blockers (CCBs) are widely recommended for hypertension treatment.
- Patient compliance with CCB therapy is crucial for successful blood pressure control and is influenced by drug tolerability.
- Generational differences in CCBs may impact their side effect profiles and tolerability.
Purpose of the Study:
- To compare the tolerability of third-generation amlodipine with latest-generation lercanidipine and lacidipine in elderly hypertensive patients.
- To evaluate differences in the incidence of edema, a common CCB side effect, among the tested agents.
Main Methods:
- The COHORT trial involved 828 elderly hypertensive patients (age ≥ 60 years).
- Patients received either amlodipine, lercanidipine, or lacidipine.
- Edema incidence was the primary endpoint, assessing tolerability.
Main Results:
- All three CCBs demonstrated similar efficacy in reducing blood pressure.
- Lercanidipine and lacidipine exhibited significantly better tolerability compared to amlodipine.
- This improved tolerability was observed in both monotherapy and combination therapy settings.
Conclusions:
- Latest-generation dihydropyridine CCBs, lercanidipine and lacidipine, offer superior tolerability over amlodipine in elderly hypertensive individuals.
- Enhanced tolerability of newer CCBs can potentially improve patient adherence and achievement of guideline-recommended blood pressure targets.