Key result
Lercanidipine was superior to nifedipine for incident stroke in newly diagnosed hypertension patients over a six-year period (HR 0.526; 95% CI 0.347-0.797; p=0.0025).
Why the study?
Does lercanidipine improve long-term cardiovascular, stroke, renal, and mortality outcomes compared to other calcium channel blockers in patients with newly diagnosed hypertension?
Cohort (n=144,630)
Does lercanidipine improve long-term cardiovascular, stroke, renal, and mortality outcomes compared to other calcium channel blockers in patients with newly diagnosed hypertension?
Hazard Ratio: 0.526 (95% CI 0.347–0.797)
p-value: p=0.0025
In patients with newly diagnosed hypertension, lercanidipine may offer superior long-term protection against incident stroke compared to nifedipine.
Lercanidipine may lower stroke risk versus nifedipine in new hypertension; leaves open effects on other CV, renal, or mortality outcomes pending RCTs.
OBJECTIVE: Calcium channel blockers (CCBs) have been proved to have beneficial effects on cardiovascular (CV) outcomes, especially in stroke. Lercanidipine, a highly lipophilic CCB, lacks data regarding long-term outcomes including: CV, stroke, renal and all-cause mortality. This retrospective cohort study aims to clarify this. PATIENTS AND METHODS: A total of 144,630 newly diagnosed hypertension (HTN) patients (age: 18-65 years) in 2005 from the Taiwan's National Health Insurance Research Database were enrolled in this observational study. A pure hypertension population was fetched by excluding all chronic diseases in the Charlson Comorbidities Index. Patients were stratified into the lercanidipine group (n = 1303) and the propensity-score-matched comparative group (nifedipine, amlodipine or felodipine, n = 15,301). RESULTS: Compared to other CCBs, lercanidipine didn't have a significant difference on the study endpoints. In individual head-to-head comparisons, lercanidipine was shown to be superior to nifedipine in incident stroke with an adjusted HR with 95% CI of 0.526 (0.347-0.797) (p = .0025). The key limitations were that personal variables, such as smoking habits, alcohol intake, body mass index and physical activity and blood pressure profiles were not available in the nationwide registry database. CONCLUSION: In newly diagnosed patients with hypertension, lercanidipine was superior to nifedipine in the six-year period when the analyzed endpoint was stroke.
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Cheng et al. (2017) conducted a cohort in newly diagnosed hypertension (n=144,630). Lercanidipine vs. Other calcium channel blockers (nifedipine, amlodipine or felodipine) was evaluated on incident stroke (HR 0.526, 95% CI 0.347-0.797, p=0.0025). Lercanidipine was superior to nifedipine for incident stroke in newly diagnosed hypertension patients over a six-year period (HR 0.526; 95% CI 0.347-0.797; p=0.0025).
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