title: Association between calcium channel blockers and gingival hyperplasia.
abstract: OBJECTIVE
  To study the effect of the dose and type of calcium channel blockers (CCBs) on the risk of gingival hyperplasia and to quantify this association.
  
  
  METHODS
  The study was conducted within the Integrated Primary Care Information Project in The Netherlands. A nested case-control study was designed within a cohort of all patients who were new users of either CCBs or drugs interacting with the renin-angiotensin system (RAS). Cases were all individuals with a validated diagnosis of gingival hyperplasia. Controls were matched on age, gender and index date.
  
  
  RESULTS
  Within the study population, 103 cases of gingival hyperplasia were identified and matched to 7677 controls. The risk of gingival hyperplasia was higher in current users of CCBs [adjusted odds ratio (OR(adj)) 2.2, 95% confidence intervals (95% CI): 1.4-3.4], especially in dihydropyridines (OR(adj) 2.1, 95% CI: 1.3-3.5) and benzothiazepine derivatives (OR(adj) 2.9, 95% CI: 1.3-6.5) than in RAS drug users. The risk increased in patients using more than the recommended daily dose (OR(adj) 3.0, 95% CI: 1.6-5.5) and when the duration of current use was <1 month (OR(adj) 5.2, 95% CI: 2.1-12.6).
  
  
  CONCLUSIONS
  This study shows that the risk of gingival hyperplasia is twofold higher in current users of CCBs than in users of RAS drugs. The association was dose dependent and the highest for dihydropyridines or benzothiazepine derivates.
authors.affiliation: Department of Medical Informatics, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Gaganpreet
authors.initials: G
authors.lastname: Kaur
authors.forename: Katia M C
authors.initials: KM
authors.lastname: Verhamme
authors.forename: Jeanne P
authors.initials: JP
authors.lastname: Dieleman
authors.forename: Ann
authors.initials: A
authors.lastname: Vanrolleghem
authors.forename: Eva M
authors.initials: EM
authors.lastname: van Soest
authors.forename: Bruno H Ch
authors.initials: BH
authors.lastname: Stricker
authors.forename: Miriam C J M
authors.initials: MC
authors.lastname: Sturkenboom
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects*; D016022:Case-Control Studies; D015986:Confounding Factors, Epidemiologic; D004095:Dihydropyridines / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D005885:Gingival Hyperplasia / Q000139:chemically induced*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D013841:Thiazepines / Q000009:adverse effects
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D013841:Thiazepines