title: Efficacy of Calcium Channel Blockers on Major Cardiovascular Outcomes for the Treatment of Hypertension in Asian Populations: A Meta-analysis.
abstract: Whether calcium channel blockers exert a greater effect on cardiovascular risk reduction in Asian populations than other antihypertensive agents is unclear. We conducted a meta-analysis of hypertension trials of dihydropyridine calcium channel blockers in Asian populations to clarify this association.
  
  
  
  EMBASE, MEDLINE, and Cochrane databases were searched (from inception to August 2016) for randomized controlled trials on cardiovascular death, major adverse cardiovascular events, stroke, congestive heart failure, and coronary revascularization in Asian persons with hypertension. We identified 9 trials that reported data specific to Asian populations (N = 29,643). These trials included 1 placebo-controlled trial and 8 active comparator trials; of these, 5 had angiotensin receptor blockers as the active comparator.
  
  
  
  One placebo-controlled trial (n = 9711) showed significantly reduced cardiovascular mortality, major adverse cardiovascular events, and stroke with calcium channel blockers. Among 8 active comparator trials (n = 19,932), there were no significant differences in mortality (relative risk [RR], 1.10; 95% confidence interval [CI], 0.72-1.67; I2= 0.0%), major adverse cardiovascular events (RR, 1.02; 95% CI, 0.90-1.15; I2= 0.0%), stroke (RR, 0.97; 95% CI, 0.80-1.17; I2= 0.0%), congestive heart failure (RR, 1.01; 95% CI, 0.51-2.00; I2= 53.7), or coronary revascularization rates (RR, 0.98; 95% CI, 0.76-1.25; I2= 0.0%) in the calcium channel blocker group compared with other antihypertensive agents. When restricting the meta-analysis to angiotensin receptor blocker comparators (n = 10,384), there were no significant differences in cardiovascular outcomes.
  
  
  
  There is no evidence that dihydropyridine calcium channel blockers are superior to other antihypertensive agents in Asian populations for the treatment of hypertension.
authors.affiliation: Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada. Electronic address: karen.tran4@vch.ca.
authors.forename: Karen C
authors.initials: KC
authors.lastname: Tran
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Leung
authors.affiliation: Department of Medicine, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Tang
authors.affiliation: Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
authors.forename: Hude
authors.initials: H
authors.lastname: Quan
authors.affiliation: Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Center for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada.
authors.forename: Nadia A
authors.initials: NA
authors.lastname: Khan
mesh_terms: D000959:Antihypertensive Agents / Q000145:classification / Q000494:pharmacology; D044466:Asian People; D002121:Calcium Channel Blockers / Q000494:pharmacology*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D002319:Cardiovascular System / Q000187:drug effects / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000208:ethnology / Q000378:metabolism / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers