title: Efficacy and safety of calcium channel blocker/diuretics combination therapy in hypertensive patients: a meta-analysis.
abstract: Although recent guidelines recommend the combination of calcium channel blockers (CCBs) and thiazide (-like) diuretics, this combination is not widely used in clinical practice. The aim of this meta-analysis was to assess the efficacy and safety of this combination regarding the following endpoints: all-cause and cardiovascular mortality, myocardial infarction, and stroke. Four studies with a total of 30,791 of patients met the inclusion criteria. The combination CCB/thiazide (-like) diuretic was associated with a significant risk reduction for myocardial infarction (risk ratio [RR], 0.83; 95% confidence interval [CI], 0.73-0.95) and stroke (RR, 0.77; CI, 0.64-0.92) compared with other combinations, whereas it was similarly effective compared with other combinations in reducing the risk of all-cause (RR, 0.89; CI, 0.75-1.06) and cardiovascular (RR, 0.89; CI 0.71-1.10) mortality. Elderly patients with isolated systolic hypertension may particularly benefit from such a combination, since both drug classes have been shown to confer cerebrovascular protection.
authors.affiliation: Department of Cardiology and Clinical Research, University Hospital, Bern, Switzerland.
authors.forename: Stefano F
authors.initials: SF
authors.lastname: Rimoldi
authors.forename: Franz H
authors.initials: FH
authors.lastname: Messerli
authors.forename: Patricia
authors.initials: P
authors.lastname: Chavez
authors.forename: Giulio G
authors.initials: GG
authors.lastname: Stefanini
authors.forename: Urs
authors.initials: U
authors.lastname: Scherrer
mesh_terms: D000367:Age Factors; D000368:Aged; D002121:Calcium Channel Blockers / Q000009:adverse effects* / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000401:mortality; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D049993:Sodium Chloride Symporter Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D020521:Stroke / Q000453:epidemiology; D016896:Treatment Outcome
chemical_list: D002121:Calcium Channel Blockers; D049993:Sodium Chloride Symporter Inhibitors