title: Use of dihydropyridine calcium channel blockers in the management of hypertension in Eastern Asians: a scientific statement from the Asian Pacific Heart Association.
abstract: Dihydropyridine calcium channel blockers (CCBs) are widely prescribed for the management of hypertension in Eastern Asians. In this study, the Asian Pacific Heart Association's Writing Committee reviewed randomized controlled trials that were conducted in the Eastern Asian region and compared a CCB with an antihypertensive drug of another class. These trials studied ambulatory blood pressure, measures of target organ damage and cardiovascular events as outcomes. Eleven trials studied ambulatory blood pressure in hypertensive patients and demonstrated that the 24-h blood pressure reduction with CCBs was greater than with other classes of antihypertensive drugs, with a weighted mean difference of 5 mm Hg systolic and 3 mm Hg diastolic. Twelve trials that studied various measurements of target organ damage in hypertensive patients produced inconsistent results when comparing CCBs and other classes of antihypertensive drugs. Four trials that studied the hard outcomes had limited power, but confirmed the findings of previous placebo-controlled trials in the region and actively controlled trials in Europe and North America; they suggested that CCBs provided superior protection against stroke and that some agents, such as amlodipine, also provided similar protection against myocardial infarction. In conclusion, CCBs should be recommended as a preferred drug for the management of hypertension in the Eastern Asian region to improve blood pressure control and to confront the aggravating epidemic of stroke and coronary heart disease.
authors.affiliation: Centre for Epidemiological Studies and Clinical Trials, Ruijin Hospital, The Shanghai Institute of Hypertension, Shanghai Jiaotong University School of Medicine, Shanghai, China. jiguangw@gmail.com
authors.forename: Ji-Guang
authors.initials: JG
authors.lastname: Wang
authors.forename: Kazuomi
authors.initials: K
authors.lastname: Kario
authors.forename: Titus
authors.initials: T
authors.lastname: Lau
authors.forename: Yong Quek
authors.initials: YQ
authors.lastname: Wei
authors.forename: Chang Gyu
authors.initials: CG
authors.lastname: Park
authors.forename: Cheol Ho
authors.initials: CH
authors.lastname: Kim
authors.forename: Jun
authors.initials: J
authors.lastname: Huang
authors.forename: Weizhong
authors.initials: W
authors.lastname: Zhang
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
authors.forename: Peter
authors.initials: P
authors.lastname: Yan
authors.forename: Dayi
authors.initials: D
authors.lastname: Hu
mesh_terms: D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004095:Dihydropyridines / Q000627:therapeutic use*; D005202:Asia, Eastern / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000208:ethnology*; D016032:Randomized Controlled Trials as Topic; D012955:Societies, Medical; D016896:Treatment Outcome
chemical_list: D002121:Calcium Channel Blockers; D004095:Dihydropyridines; C038806:1,4-dihydropyridine