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Comparative Effectiveness of Lercanidipine and Amlodipine on Major Adverse Cardiovascular Events in Hypertensive
Jinsung Jeon1, Sunwoo Ryoo2, Seungmi Oh3
1Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.
Insights
Lercanidipine and amlodipine show similar effectiveness in preventing major adverse cardiovascular events (MACE) for hypertension patients. Lercanidipine may be a preferred choice due to potentially fewer side effects.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Lercanidipine is a newer calcium channel blocker with proven antihypertensive effects and a favorable side effect profile.
- Hypertension management is crucial for cardiovascular disease prevention.
Purpose of the Study:
- To compare the efficacy of lercanidipine versus amlodipine in preventing major adverse cardiovascular events (MACE).
- To evaluate lercanidipine as a potential alternative for hypertension management.
Main Methods:
- A retrospective observational study involving 6,029 hypertensive patients from South Korea (2017-2021).
- Propensity score matching (PSM) was used to balance baseline characteristics between lercanidipine and amlodipine groups.
- The primary endpoint was the incidence of MACE over a 3-year follow-up.
Main Results:
- After PSM, MACE incidence was numerically lower in the lercanidipine group (2.8%) compared to the amlodipine group (4.1%), but not statistically significant (P=0.11).
- Both treatments achieved comparable blood pressure control over the follow-up period.
- Pre-matching analysis indicated higher baseline cardiovascular risk and MACE incidence in the lercanidipine group.
Conclusions:
- Lercanidipine is as effective as amlodipine in preventing MACE in hypertensive patients.
- Lercanidipine presents a viable option for hypertension management, potentially offering a better side effect profile.
Background:
Lercanidipine, a newer-generation calcium channel blocker, is recognized for its effective antihypertensive properties and reduced side effects. This study aims to compare the effectiveness of lercanidipine and amlodipine in preventing major adverse cardiovascular events (MACE) in hypertensive patients.
Methods:
A multicenter, retrospective observational study was conducted using the electronic medical records database from 3 tertiary hospitals in South Korea between 2017 and 2021. Hypertensive patients treated with either amlodipine or lercanidipine were analyzed. Propensity score matching (PSM) was utilized to minimize confounders, matching patients in a 3:1 ratio. The primary endpoint was the incidence of MACE, a composite of cardiovascular death, myocardial infarction, stroke, heart failure hospitalizations, and coronary revascularization over a 3-year follow-up period.
Results:
A total of 47,640 patients were evaluated, and 6,029 patients were matched. Before PSM, the lercanidipine group had a higher cardiovascular risk (SCORE-2/SCORE-2OP value: 11.6% ± 9.2 vs. 10.9% ± 8.8, P < 0.01) and a higher incidence of MACE compared to the amlodipine group (4.1% vs. 3.4%, P < 0.01). After PSM, the incidence of MACE was numerically lower in the lercanidipine group compared to the amlodipine group (2.8% vs. 4.1%, P = 0.11), though this difference was not statistically significant. Blood pressure control remained comparable between the 2 groups over the 3-year follow-up period.
Conclusions:
Lercanidipine demonstrated comparable effectiveness to amlodipine in preventing MACE among hypertensive patients. Given its comparable antihypertensive efficacy and potential for fewer side effects based on prior studies, lercanidipine may be considered a preferable option for hypertension management.
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