Calcium channel blockers versus other classes of drugs for hypertension

Chen, Ning; Zhou, Muke; Yang, Mi; Guo, Jian; Zhu, Cairong; Yang, Jie; Wang, Yucai; Yang, Xue; He, Li

doi:10.1002/14651858.cd003654.pub4

Cited by 57 publications

(21 citation statements)

References 84 publications

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“…The results are not very different from other meta-analyses [51,52]. Hence we assume that our results would not be substantially different if they were based on other meta-analyses of antihypertensive drug trials.…”

Section: Discussioncontrasting

confidence: 42%

Choice of generic antihypertensive drugs for the primary prevention of cardiovascular disease - A cost-effectiveness analysis

Wisløff

Selmer

Halvorsen

et al. 2012

BMC Cardiovasc Disord

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BackgroundHypertension is one of the leading causes of cardiovascular disease (CVD). A range of antihypertensive drugs exists, and their prices vary widely mainly due to patent rights. The objective of this study was to explore the cost-effectiveness of different generic antihypertensive drugs as first, second and third choice for primary prevention of cardiovascular disease.MethodsWe used the Norwegian Cardiovascular Disease model (NorCaD) to simulate the cardiovascular life of patients from hypertension without symptoms until they were all dead or 100 years old. The risk of CVD events and costs were based on recent Norwegian sources.ResultsIn single-drug treatment, all antihypertensives are cost-effective compared to no drug treatment. In the base-case analysis, the first, second and third choice of antihypertensive were calcium channel blocker, thiazide and angiotensin-converting enzyme inhibitor. However the sensitivity and scenario analyses indicated considerable uncertainty in that angiotensin receptor blockers as well as, angiotensin-converting enzyme inhibitors, beta blockers and thiazides could be the most cost-effective antihypertensive drugs.ConclusionsGeneric antihypertensives are cost-effective in a wide range of risk groups. There is considerable uncertainty, however, regarding which drug is the most cost-effective.

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Section: Discussioncontrasting

confidence: 42%

Choice of generic antihypertensive drugs for the primary prevention of cardiovascular disease - A cost-effectiveness analysis

Wisløff

Selmer

Halvorsen

et al. 2012

BMC Cardiovasc Disord

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“…Diabetes likely requires years to develop cardiovascular complications (Verdecchia 2004), so we favour the mechanism involving lesser reduction of central aortic pressure by beta-blockers. Vasodilating beta-blockers (Broeders 2000; Kalinowski 2003; Pucci 2016) have been shown to reduce central pressures better than conventional beta-blockers (Kamp 2010; Polónia 2010); most probably because vasodilatation favourably alters the pattern of the pressure wave reflecting back from the periphery, thereby lowering the central pressure. Nonetheless, carvedilol and nebivolol also cause bradycardia, which is thought to be the principal mechanism whereby atenolol with or without thiazide may be less able to lower the central pressure than amlodipine with or without perindopril (Williams 2006).…”

Section: Discussionmentioning

confidence: 99%

“…We also screened the reference lists of 41 potentially eligible studies and 25 relevant reviews and guidelines (Balamuthusamy 2009; Bangalore 2007; Bangalore 2008; Bath 2014; Carlberg 2004; Chen 2010; Dahlöf 2007; ESH-ESC 2013; Gradman 2010; Howlett 2014; James 2014; Jennings 2013; Khan 2006; Kuyper 2014; Larochelle 2014; NICE 2006; Poirier 2014; Pucci 2016; Ripley 2014; Sander 2011; Sciarretta 2011; Thomopoulos 2015; Wong 2014a; Wong 2014b; Wright 2009). In addition, we searched the World Health Organization International Clinical Trials Registry Platform (www.who.int/trialsearch) using the terms (beta-blocker OR beta-blockers) AND hypertension on 06 July 2015.…”

Section: Methodsmentioning

confidence: 99%

“…The autonomic nervous system has been known to play a role in blood pressure control since 1949 (Smithwick 1949). The principal adrenergic receptors present in the human cardiovascular system are the β1, β2, and α1 receptors (Fergus 2015; Pucci 2016). Beta-blockers vary in their β1/β2-adrenergic receptor selectivity and vasodilatory properties, and this diversity has given rise to their classification into first, second, and third generation.…”

Section: Introductionmentioning

confidence: 99%

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Beta-blockers for hypertension

Wiysonge

Bradley

Volmink

et al. 2017

Cochrane Database of Systematic Reviews

243

114

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“…1,6 The relative abundance of the medication in the vascular smooth muscle promotes arterial dilatation, resulting in decreased blood pressure. In addition, the presence of L-type calcium channels in cardiac myocytes and the resultant blockade of calcium influx have a negative inotropic and chronotropic effect on the myocardium.…”

Section: Discussionmentioning

confidence: 99%

Conventional and Unconventional Lifesaving Therapies in an Adolescent With Amlodipine Ingestion

Reuter‐Rice

Peterson

2016

Critical Care Nurse

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Amlodipine, a dihydropyridine calcium channel blocker, is commonly prescribed for the treatment of hypertension. Ingestion of an overdose leads to severe hypotension; if the hypotension is not treated, death may be imminent. Conventional and unconventional interventions were used to treat an adolescent who ingested a life-threatening dose of amlodipine. Severe hypotension resistant to conventional treatment with intralipids and hyperinsulinemia-euglycemia therapy led to the use of plasmapheresis and a pneumatic antishock garment as lifesaving measures. Plasmapheresis has been described in only one other case of severe amlodipine overdose, and the use of a pneumatic antishock garment has never been described in the management of a calcium channel blocker overdose. Because short-term use of a pneumatic antishock garment has associated risks, the critical care nurse's anticipation of side effects and promotion of safe use of the garment were instrumental in the patient's care and outcome. A standard daily dose is 2.5 to 10 mg, and the mean half-life is 30 to 55 hours.1 When inappropriate amounts are accidentally or intentionally ingested, severe hypotension and slow metabolic clearance often lead to fatality.2 The mechanism of action of amlodipine lowers the systemic vascular resistance and reduces the influx of extracellular calcium, resulting in inotropic and chronotropic effects on the myocardium. Amlodipine overdoses have been associated with near-fatal and fatal instances of hypotension and reflex tachycardia, hyperglycemia, metabolic acidosis, and pulmonary edema.3-12 Conventional therapies include calcium replacement, vaso pressors, intralipids, high-dose insulin-euglycemia therapy, and plasmapheresis to maintain end-organ perfusion. [5][6][7]10,11,[13][14][15] Critical care nurses are expected to understand conventional multimodal therapies for patients with amlodipine overdose while providing life-sustaining bedside care. At times, unconventional therapies may be used to maintain life support.

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Calcium channel blockers versus other classes of drugs for hypertension

Cited by 57 publications

References 84 publications

Choice of generic antihypertensive drugs for the primary prevention of cardiovascular disease - A cost-effectiveness analysis

Choice of generic antihypertensive drugs for the primary prevention of cardiovascular disease - A cost-effectiveness analysis

Beta-blockers for hypertension

Conventional and Unconventional Lifesaving Therapies in an Adolescent With Amlodipine Ingestion

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