ORIGINALARTICLE : Amlodipine and cardiovascular outcomes in hypertensive patients: meta-analysis comparing amlodipine-based versus other antihypertensive therapy

• Published in: The Korean journal of internal medicine Vol. 29; no. 3; pp. 315 - 324
• Main Authors: Seung Ah Lee, Hong Mi Choi, Hye Jin Park, Su Kyoung Ko, Hae Young Lee
• Format: Journal Article
• Language: Korean
• Published: 대한내과학회 30.05.2014
• Subjects: Amlodipine; Calcium channel blockers; Hypertension; Meta-analysis
• ISSN: 1226-3303; 2005-6648

Background/Aims: This meta-analysis compared the effects of amlodipine besylate,a charged dihydropyridine-type calcium channel blocker (CCB), with othernon-CCB antihypertensive therapies regarding the cardiovascular outcome. Methods: Data from seven long-term outcome trials comparing the cardiovascularoutcomes of an amlodipine-based regimen with other active regimens werepooled and analyzed. Results: The risk of myocardial infarction was significantly decreased with anamlodipine-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 strokewas 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 anamlodipine-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 ß-blockersand diuretics, amlodipine showed a comparable risk. Amlodipine-based regimensdemonstrated 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 wellas all-cause mortality compared with non-CCB-based regimens, indicating itsbenefit for high-risk cardiac patients.