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Amlodipine and cardiovascular outcomes in hypertensive patients: meta-analysis comparing amlodipine-based versus
Seung-Ah Lee1, Hong-Mi Choi1, Hye-Jin Park2
1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Insights
Amlodipine significantly reduces cardiovascular events and mortality compared to non-calcium channel blockers (CCBs). This antihypertensive therapy offers benefits for high-risk cardiac patients.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Amlodipine besylate is a dihydropyridine-type calcium channel blocker (CCB).
- Antihypertensive therapies vary in cardiovascular outcomes.
Purpose of the Study:
- To compare cardiovascular outcomes of amlodipine-based regimens with non-CCB antihypertensive therapies.
- To evaluate amlodipine's efficacy in high-risk cardiac patients.
Main Methods:
- Meta-analysis of seven long-term outcome trials.
- Pooled analysis of cardiovascular outcomes comparing amlodipine-based and other active regimens.
Main Results:
- Amlodipine significantly decreased myocardial infarction and stroke risk.
- Amlodipine showed a 10% risk reduction in overall cardiovascular events and total mortality.
- Slight, marginally significant increase in heart failure risk with amlodipine was observed, comparable to beta-blockers and diuretics.
Conclusions:
- Amlodipine-based regimens reduce total cardiovascular events and all-cause mortality versus non-CCB therapies.
- Amlodipine demonstrates significant benefits for high-risk cardiac patients.
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 β-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.
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