Rimoldi SF et al. J Clin Hypertens (Greenwich). 2015;17(3):193-199. Efficacy and safety of calcium channel blocker/diuretics combination therapy in hypertensive.

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Presentation transcript:

Rimoldi SF et al. J Clin Hypertens (Greenwich). 2015;17(3): Efficacy and safety of calcium channel blocker/diuretics combination therapy in hypertensive patients: a meta-analysis

Methods Four studies (ELSA, VALUE, FEVER, COPE) with a total of patients fulfilled the inclusion criteria and were included. Random-effects meta-analysis comparing ischemic outcomes between patients treated with a CCB/thiazide diuretic combination and those treated with other antihypertensive medications at maximum available follow up.

Characteristics of the studies included in the analysis ELSAVALUEFEVERCOPE Number of randomized patients Active treatmentCCB/DIU ComparatorβB/DIUARB/DIUDIU CCB/ARB or CCB/βB BP at entry (mmHg)164/101 vs 163/101155/88 vs 154/87154/91 vs 154/91 154/89 vs 154/89 and 154/89 Drop in SBP (mmHg) 21.6 vs vs vs vs 19.3 and 20.1 Drop in DBP (mmHg) 15.5 vs vs vs vs 11.8 and 12.0

Results The combination of a CCB with a thiazide (-like) diuretic exhibited similar risks of all cause mortality (RR, 0.89; 95% CI, ) and cardiovascular mortality (RR, 0.89; CI, ) compared with other hypertensive medications. Moreover, the combination CCB/ thiazide (-like) diuretic was associated with a significant risk reduction for MI (RR, 0.83; CI, ) and stroke (RR, 0.77; CI, ) compared with other hypertensive medications.

Thiazide diuretics/calcium channel blockers: more effective than other combinations in reducing stroke CCB, calcium channel blocker; CI, confidence internval; DIU, diuretic.

Conclusions Calcium channel blocker/diuretic combination therapy is safe and efficient in reducing morbidity and mortality in hypertension. Calcium channel blocker/diuretic combination therapy may be particularly useful to reduce systolic blood pressure and to confer cerebrovascular protection.