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November 20, 2015American Journal of Therapeutics

In hypertensive patients with CAD, calcium channel blockers reduced stroke risk but increased CHF risk compared to other antihypertensives, with no difference in other major CV outcomes.

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Why the study?

Do calcium channel blockers improve major cardiovascular outcomes compared with other antihypertensive medications in hypertensive patients with previous stroke and/or CAD?

Population

Hypertensive patients with concomitant previous stroke and/or coronary artery disease from 7 unique trials.

Comparison

Calcium channel blockers (CCBs) vs Other classes of antihypertensive medications

Design

Meta-analysis, Randomized (inclusion criteria for trials)

Follow-up

≥6 months

Key result

In hypertensive patients with CAD, calcium channel blockers reduced stroke risk but increased CHF risk compared to other antihypertensives, with no difference in other major CV outcomes.

Authors

BJBarrett W. JeffersJRJeffery RobbinsRBRahul Bhambri

Discussion

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Member takes

Overview

Clinicians should weigh stroke benefit against CHF risk when choosing CCBs in hypertensive CAD; extends evidence on outcome-specific antihypertensive effects.

Study Design

Type

Meta-Analysis

Structured PICO

Do calcium channel blockers improve major cardiovascular outcomes compared with other antihypertensive medications in hypertensive patients with previous stroke and/or CAD?

P
Population
Systematic review and meta-analysis of 7 trials assessing hypertensive patients with previous stroke and/or CAD followed for ≥6 months.
I
Intervention
Calcium channel blockers (CCBs)
C
Comparator
Other classes of antihypertensive medications (α-blockers, β-blockers, angiotensin II receptor blockers, angiotensin-converting enzyme inhibitors, or diuretics)
O
Outcome
Major cardiovascular outcomes including all-cause death, CV death, major CV events (myocardial infarction, congestive heart failure, stroke, and CV death), MI, stroke, or CHFhard clinical

In hypertensive patients with CAD, CCBs are associated with a reduced risk of stroke but an increased risk of CHF compared to other antihypertensives, while showing similar efficacy in patients with prior stroke.

Cite This Study

Jeffers et al. (2015) conducted a meta-analysis in Hypertension with previous stroke and/or coronary artery disease. Calcium channel blockers vs. Other classes of antihypertensive medications was evaluated on Major cardiovascular outcomes. In hypertensive patients with CAD, calcium channel blockers reduced stroke risk but increased CHF risk compared to other antihypertensives, with no difference in other major CV outcomes.

synapsesocial.com/papers/6a79cecdbdf697b3de0262f9https://doi.org/10.1097/mjt.0000000000000369
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