Why the study?
Does the combination of calcium channel blockers and thiazide diuretics reduce mortality, myocardial infarction, and stroke in hypertensive patients compared to other combinations?
Does the combination of calcium channel blockers and thiazide diuretics reduce mortality, myocardial infarction, and stroke in hypertensive patients compared to other combinations?
Combination therapy with CCBs and thiazide diuretics provides significant cardiovascular protection by reducing the risk of myocardial infarction and stroke in hypertensive patients.
Supports CCB/thiazide preference in hypertension; confirms CV risk reduction across pooled trials.
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.
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Rimoldi et al. (2015) studied this question.
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