Calcium channel blockers versus other classes of drugs for hypertension

Zhu, Jiaying; Chen, Ning; Zhou, Muke; Guo, Jian; Zhu, Cairong; Zhou, Jie; Ma, Mengmeng

doi:10.1002/14651858.cd003654.pub5

Cited by 21 publications

(23 citation statements)

References 132 publications

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“…Thiazide-type diuretics have consistently been demonstrated to be superior in reducing cardiovascular events compared with other antihypertensive drug classes, particularly heart failure. 12,[14][15][16][17][18] Another recent post hoc analysis of SPRINT using a different methodology than ours evaluating only intensive arm patients, also showed thiazide-type diuretic exposure to be associated with significantly less heart failure. 19 This finding is consistent with our study although our analysis includes both randomization arms and revealed improved outcomes beyond heart failure reductions.…”

Section: Discussionmentioning

confidence: 92%

“…This differs from previous evidence of possible calcium channel blocker superiority in stroke reduction compared with RAS blockers, beta-blockers, and primary antihypertensive drug classes as a group. 11,[13][14][15][16][17][18] This could be due to a lower incidence of stroke in SPRINT (patients with a baseline history of stroke were excluded) compared with other studies, thus insufficient power to detect true differences. Although not statistically significant, a trend towards increased heart failure events with longer calcium channel blocker use is consistent with meta-analyses showing a higher risk when compared with other antihypertensive drug classes.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Antihypertensive Drug Class on Outcomes in SPRINT

et al. 2022

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Background: The primary objective of this analysis is to assess if greater exposure to any major antihypertensive drug class was associated with reduced primary composite outcome events in SPRINT (Systolic Blood Pressure Intervention Trial). Methods: This is a secondary analysis of the SPRINT trial evaluating whether longitudinal, time varying exposure to any major antihypertensive drug class had any impact on primary outcome events, after adjusting for effects of randomization arm, time varying achieved systolic blood pressure, other drug class exposure, and baseline characteristics. Results: Nine thousand two hundred fifty-two participants were included. After adjustments, exposure of one year or greater to thiazide-type diuretics or renin-angiotensin system blockers was associated with significantly fewer primary events than exposure of less than one year (hazard ratio, 0.78 [95% CI, 0.64–0.94]). There was no significant difference with longer versus shorter exposure to calcium channel blockers. Greater exposure to beta-blockers was associated with an increase in primary events compared with exposure of <1 year (hazard ratio, 1.35 [95% CI, 1.13–1.62]). Furthermore, thiazide-type diuretics were associated with a reduction in heart failure events and renin-angiotensin system blockers with reduced myocardial infarction. Both were associated with less cardiovascular deaths. Conclusions: The SPRINT trial demonstrated a lower target blood pressure led to reductions in adverse cardiovascular events. This analysis suggests greater exposure to thiazide-type diuretics and renin-angiotensin system blockers also contributed to reduced adverse cardiovascular events. Greater exposure to beta-blockers was associated with increased cardiovascular events.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Impact of Antihypertensive Drug Class on Outcomes in SPRINT

et al. 2022

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“…To ask about medication-related intentions, we focused on the current pharmacological treatment guidelines that support the use of antihypertensives and statins for prevention of heart disease. 20,21 Specifically, we relied on prior research to develop survey questions regarding medication-related outcomes that included ordinal measures (ranging from 1 [highly unlikely] to 5 [highly likely]) on the likelihood of switching medication, asking a physician about advertised medication, asking an insurer about advertised medication, searching for medication online, or taking medication as directed. 13,22,23 To ask about lifestyle-related intentions, we focused on nonpharmacological lifestyle interventions that have been recommended to improve outcomes in individuals at high risk of cardiovascular diseases.…”

Section: Methodsmentioning

confidence: 99%

Association of Direct-to-Consumer Advertising of Prescription Drugs With Consumer Health-Related Intentions and Beliefs Among Individuals at Risk of Cardiovascular Disease

2022

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Importance Consumers in the US are exposed to unprecedented high levels of direct-to-consumer advertising (DTCA) for prescription drugs, yet there is limited evidence regarding their effect on health-related intentions and beliefs. Objective To provide evidence on the association of DTCA for prescription drugs with consumer health-related intentions and beliefs. Design, Setting, and Participants This cross-sectional study recruited participants from a nationally representative sample of individuals at high risk of cardiovascular disease. Participants were randomly assigned into 1 of 3 study arms: (1) exposure to DTCA for heart disease medications (treatment 1 [n = 926]), (2) exposure to DTCA for heart disease medications with price disclosure (treatment 2 [n = 921]), (3) and exposure to nonpharmaceutical advertising (control group [n = 902]). Each study arm viewed five 1-minute video advertisements, totaling 5 minutes of advertising exposure. The 2 treatment arms viewed pharmaceutical advertising videos for 4 heart disease medications, and the control arm viewed nonpharmaceutical advertising videos. Participants then completed a survey questionnaire to measure medication- and lifestyle-related intentions and health-related beliefs and perceptions. Exposures Direct-to-consumer advertising for heart disease medications (treatment 1), DTCA for heart disease medications with price disclosure (treatment 2), and nonpharmaceutical advertising (control group). Main Outcomes and Measures The primary outcomes included ordinal measures of medication- and lifestyle-related intentions, health-related beliefs, and brand perceptions. Results Among the 2874 included participants (mean [SD] age, 53.8 [7.1] years; 1549 [54%] male) χ 2tests confirmed that there were no statistically significant differences in baseline demographic characteristics across study arms. There was a positive association between DTCA and medication-related behavioral intentions, including intention to switch medication (marginal effect [ME] = 0.004; P = .002) and engage in information-seeking behaviors (ME = 0.02; P = .01). There was no evidence that pharmaceutical DTCA discouraged use of nonpharmacological lifestyle interventions that can help manage heart disease (eg, diet and exercise), and DTCA exposure also had a positive association with consumers’ favorable perceptions of pharmaceutical manufacturers (competence: ME = 0.03; P = .01; innovative: ME = 0.03; P = .008). There was no evidence for differential associations of price disclosures in DTCA. Conclusions and Relevance In this cross-sectional study, results showed that brief exposure to pharmaceutical DTCA had a large and positive association with medication-related demand intentions with no offsetting negative spillovers on lifestyle-related intentions. Lack of associations with price disclosure in DTCA suggests that policy makers should consider alternative strategies to promote value-based decision-making for prescription drugs.

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“…1,4-Dihydropyridines (1,4-DHP) are nitrogen-containing heterocycles widely used for the treatment of hypertension, angina pectoris, cardiac arrhythmias, and other disorders [1,2]. 1,4-DHP derivatives were reported to possess numerous other biological activities including anticancer and antimicrobial agents.…”

Section: Introductionmentioning

confidence: 99%

1,1′-{[3,5-Bis(dodecyloxycarbonyl)-4-(naphthalen-2-yl)-1,4-dihydropyridine-2,6-diyl]bis(methylene)}bis{4-[(E)-2-(naphthalen-2-yl)vinyl]pyridin-1-ium}dibromide

Ruciņš

Kaukulis

Plotniece

et al. 2022

Molbank

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Synthesis of a double-charged cationic amphiphilic 1,4-dihydropyridine derivative with dodecyl ester groups at positions 3 and 5 of the 1,4-DHP ring was performed starting from Hantzsch type cyclization of dodecyl acetoacetate, 2-naphthaldehyde and ammonium acetate. Bromination of this compound followed by nucleophilic substitution of bromine with (E)-4-(2-(naphthalen-2-yl)vinyl)pyridine gave the desired cationic amphiphilic 1,1′-{[3,5-bis(dodecyloxycarbonyl)-4-(naphthalen-2-yl)-1,4-dihydropyridine-2,6-diyl]bis(methylene)}bis{4-[(E)-2-(naphthalen-2-yl)vinyl]pyridin-1-ium}dibromide. The obtained target compound was fully characterized by IR, UV, 1H-NMR, 13C-NMR, HRMS and microanalysis. The characterization of the cationic 1,4-DHP nanoparticles in an aqueous solution was performed by DLS measurements. The obtained results showed that the compound formed nanoparticles with an average diameter of around 300 nm, a PDI value of around 490 and a zeta-potential of around 20 mV for freshly prepared samples. However, after one week of storage at room temperature, an aggregation of nanoparticles was detected.

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Calcium channel blockers versus other classes of drugs for hypertension

Cited by 21 publications

References 132 publications

Impact of Antihypertensive Drug Class on Outcomes in SPRINT

Impact of Antihypertensive Drug Class on Outcomes in SPRINT

Association of Direct-to-Consumer Advertising of Prescription Drugs With Consumer Health-Related Intentions and Beliefs Among Individuals at Risk of Cardiovascular Disease

1,1′-{[3,5-Bis(dodecyloxycarbonyl)-4-(naphthalen-2-yl)-1,4-dihydropyridine-2,6-diyl]bis(methylene)}bis{4-[(E)-2-(naphthalen-2-yl)vinyl]pyridin-1-ium}dibromide

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