Amlodipine and cardiovascular outcomes in hypertensive patients: meta-analysis comparing amlodipine-based versus other antihypertensive therapy.
OBJECTIVE
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 β-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.
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Seung-Ah
SA
Lee
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Hong-Mi
HM
Choi
Pfizer Pharmaceuticals Korea, Ltd., Seoul, Korea.
Hye-Jin
HJ
Park
Pfizer Pharmaceuticals Korea, Ltd., Seoul, Korea.
Su-Kyoung
SK
Ko
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Hae-Young
HY
Lee
D017311:Amlodipine / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002986:Clinical Trials as Topic; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality / Q000503:physiopathology; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016017:Odds Ratio; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D017311:Amlodipine
Amlodipine; Calcium channel blockers; Hypertension; Meta-analysis