Korean J Intern Med.  2014 May;29(3):315-324. 10.3904/kjim.2014.29.3.315.

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

• Lee SA
• Choi HM
• Park HJ
• Ko SK
• Lee HY

• KMID: 1792057
• DOI: http://doi.org/10.3904/kjim.2014.29.3.315

Abstract

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.

Keyword

Amlodipine; Calcium channel blockers; Hypertension; Meta-analysis

MeSH Terms

Amlodipine/*therapeutic use
Antihypertensive Agents/*therapeutic use
Blood Pressure/*drug effects
Calcium Channel Blockers/*therapeutic use
Chi-Square Distribution
Clinical Trials as Topic
Heart Failure/etiology/mortality/*prevention & control
Humans
Hypertension/complications/diagnosis/*drug therapy/mortality/physiopathology
Myocardial Infarction/etiology/mortality/*prevention & control
Odds Ratio
Risk Factors
Stroke/etiology/mortality/*prevention & control
Treatment Outcome
Amlodipine
Antihypertensive Agents
Calcium Channel Blockers