Background and Objectives: Antihypertensive treatment with calcium channel blockers (CCBs) is consolidated in clinical practice; however, different studies observed increased risks of acute events for short-acting CCBs. This study aimed to provide real-world evidence on risks of acute cardiovascular (CV) events, hospitalizations and mortality among users of different CCB classes in secondary CV prevention. Methods: Three case–control studies were nested in a cohort of Italian elderly hypertensive CV-compromised CCBs users. Cases were subjects with CV events (n = 25,204), all-cause hospitalizations (n = 19,237), or all-cause mortality (n = 17,996) during the follow-up. Up to four controls were matched for each case. Current or past exposition to CCBs at index date was defined based on molecule, formulation and daily doses of the last CCB delivery. The odds ratio (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. Results: Compared to past users, current CCB users had significant reductions in risks of CV events [OR 0.88 (95% CI: 0.84–0.91)], hospitalization [0.90 (0.88–0.93)] and mortality [0.48 (0.47–0.49)]. Current users of long-acting dihydropyridines (DHPs) had the lowest risk [OR 0.87 (0.84–0.90), 0.86 (0.83–0.90), 0.55 (0.54–0.56) for acute CV events, hospitalizations and mortality], whereas current users of short-acting CCBs had an increased risk of acute CV events [OR 1.77 (1.13–2.78) for short-acting DHPs; 1.19 (1.07–1.31) for short-acting non-DHPs] and hospitalizations [OR 1.84 (0.96–3.51) and 1.23 (1.08–1.42)]. Conclusions: The already-existing warning on short-acting CCBs should be potentiated, addressing clinicians towards the choice of long-acting formulations.

Bettiol, A., Lucenteforte, E., Vannacci, A., Lombardi, N., Onder, G., Agabiti, N., et al. (2017). Calcium Channel Blockers in Secondary Cardiovascular Prevention and Risk of Acute Events: Real-World Evidence from Nested Case–Control Studies on Italian Hypertensive Elderly. CLINICAL DRUG INVESTIGATION, 37(12), 1165-1174 [10.1007/s40261-017-0576-2].

Calcium Channel Blockers in Secondary Cardiovascular Prevention and Risk of Acute Events: Real-World Evidence from Nested Case–Control Studies on Italian Hypertensive Elderly

Corrao, G;Corrao, G;Rea, F;
2017

Abstract

Background and Objectives: Antihypertensive treatment with calcium channel blockers (CCBs) is consolidated in clinical practice; however, different studies observed increased risks of acute events for short-acting CCBs. This study aimed to provide real-world evidence on risks of acute cardiovascular (CV) events, hospitalizations and mortality among users of different CCB classes in secondary CV prevention. Methods: Three case–control studies were nested in a cohort of Italian elderly hypertensive CV-compromised CCBs users. Cases were subjects with CV events (n = 25,204), all-cause hospitalizations (n = 19,237), or all-cause mortality (n = 17,996) during the follow-up. Up to four controls were matched for each case. Current or past exposition to CCBs at index date was defined based on molecule, formulation and daily doses of the last CCB delivery. The odds ratio (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. Results: Compared to past users, current CCB users had significant reductions in risks of CV events [OR 0.88 (95% CI: 0.84–0.91)], hospitalization [0.90 (0.88–0.93)] and mortality [0.48 (0.47–0.49)]. Current users of long-acting dihydropyridines (DHPs) had the lowest risk [OR 0.87 (0.84–0.90), 0.86 (0.83–0.90), 0.55 (0.54–0.56) for acute CV events, hospitalizations and mortality], whereas current users of short-acting CCBs had an increased risk of acute CV events [OR 1.77 (1.13–2.78) for short-acting DHPs; 1.19 (1.07–1.31) for short-acting non-DHPs] and hospitalizations [OR 1.84 (0.96–3.51) and 1.23 (1.08–1.42)]. Conclusions: The already-existing warning on short-acting CCBs should be potentiated, addressing clinicians towards the choice of long-acting formulations.
Articolo in rivista - Articolo scientifico
Aged; Aged, 80 and over; Antihypertensive Agents; Calcium Channel Blockers; Cardiovascular Diseases; Case-Control Studies; Cohort Studies; Female; Humans; Hypertension; Male; Odds Ratio; Risk; Secondary Prevention; Pharmacology (medical)
English
1165
1174
10
for the Italian Group for Appropriate Drug prescription in the Elderly (I-GrADE), Agabiti, Nera; Bartolini, Claudia; Bernabei, Roberto; Bettiol, Alessandra; Bonassi, Stefano; Caputi, Achille Patrizio; Cascini, Silvia; Chinellato, Alessandro; Corrao, Giovanni; Davoli, Marina; Fini, Massimo; Gini, Rosa; Giorgianni, Francesco; Kirchmayer, Ursula; Lapi, Francesco; Lombardi, Niccolò; Lucenteforte, Ersilia; Mugelli, Alessandro; Onder, Graziano; Rea, Federico; Roberto, Giuseppe; Sorge, Chiara; Tari, Michele; Trifirò, Gianluca; Vannacci, Alfredo; Vetrano, Davide Liborio; Vitale, Cristiana
Bettiol, A., Lucenteforte, E., Vannacci, A., Lombardi, N., Onder, G., Agabiti, N., et al. (2017). Calcium Channel Blockers in Secondary Cardiovascular Prevention and Risk of Acute Events: Real-World Evidence from Nested Case–Control Studies on Italian Hypertensive Elderly. CLINICAL DRUG INVESTIGATION, 37(12), 1165-1174 [10.1007/s40261-017-0576-2].
Bettiol, A; Lucenteforte, E; Vannacci, A; Lombardi, N; Onder, G; Agabiti, N; Vitale, C; Trifirò, G; Corrao, G; Roberto, G; Mugelli, A; Chinellato, A; for the Italian Group for Appropriate Drug prescription in the Elderly, (; Agabiti, N; Bartolini, C; Bernabei, R; Bettiol, A; Bonassi, S; Caputi, A; Cascini, S; Chinellato, A; Corrao, G; Davoli, M; Fini, M; Gini, R; Giorgianni, F; Kirchmayer, U; Lapi, F; Lombardi, N; Lucenteforte, E; Mugelli, A; Onder, G; Rea, F; Roberto, G; Sorge, C; Tari, M; Trifirò, G; Vannacci, A; Vetrano, D; Vitale, C
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/185506
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