Efficacy and Safety of Calcium Channel blocker/diuretics Combination Therapy in Hypertensive Patients: A Meta-Analysis

J Clin Hypertens (Greenwich). 2015 Mar;17(3):193-9. doi: 10.1111/jch.12462. Epub 2015 Jan 5.

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.

Publication types

  • Meta-Analysis

MeSH terms

  • Age Factors
  • Aged
  • Calcium Channel Blockers / adverse effects*
  • Calcium Channel Blockers / therapeutic use*
  • Cardiovascular Diseases / mortality
  • Drug Therapy, Combination
  • Humans
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Prevalence
  • Risk Factors
  • Sodium Chloride Symporter Inhibitors / adverse effects*
  • Sodium Chloride Symporter Inhibitors / therapeutic use*
  • Stroke / epidemiology
  • Treatment Outcome

Substances

  • Calcium Channel Blockers
  • Sodium Chloride Symporter Inhibitors