Efficacy and Safety of Dihydropyridine Calcium Channel Blockers for Primary Hypertension: A Bayesian Network Meta-analysis.

IF 1.5 Q3 PERIPHERAL VASCULAR DISEASE

Current Hypertension Reviews Pub Date : 2025-02-24 DOI:10.2174/0115734021357729250214090452

Huiduo Wang, Hongxin Yang, Zhiyong Zhang, Hao Guo

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引用次数: 0

Abstract

Background: Dihydropyridine-calcium channel blockers (DHP-CCBs) are effective first-line blood pressure-lowering agents for primary hypertension. However, data comparing the variations in efficacy and safety between different types of DHP-CCBs are scarce.

Aims and objectives: This study aimed to summarize the latest evidence on the benefits and harms of seven DHP-CCBs (amlodipine, levamlodipine, felodipine, lacidipine, nitrendipine, nifedipine, and benidipine).

Methods: A meta-analysis of DHP-CCBs was carried out to explore differences in efficacy and safety. We searched PubMed, Embase, the Cochrane Library, CNKI, Wanfang Data, and VIP databases from inception to September, 2023, for randomized controlled trials (RCTs) comparing DHP-CCBs. The main outcomes were blood pressure lowering and adverse events (AEs) during treatment.

Results: We included 181 RCTs (21,383 patients) in this analysis. In terms of efficacy, levamlodipine ranked highest in reducing office blood pressure (surface under the cumulative ranking systolic blood pressure = 80.81%, diastolic blood pressure [DBP] = 82.42%) and 24-h ambulatory DBP (98.07%). Felodipine had the highest probability of reducing 24-h ambulatory blood pressure (80.65%). Regarding safety, levamlodipine had the least impact on heart rate (85.71%). In terms of AEs, benidipine had the highest rate for cardiovascular (86.58%) and digestive system (93.57%) AEs. Nifedipine and amlodipine had the highest rates of central (80.65%) and peripheral nervous system (83.28%) AEs, respectively. Levamlodipine exhibited significantly lower rates of total AEs (1.24%), central nervous system AEs (1.28%), and cardiovascular system AEs (3.62%) than the other interventions.

Conclusion: In the office setting, levamlodipine may be the best treatment for primary hypertension, and lacidipine shows good safety.

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来源期刊

Current Hypertension Reviews PERIPHERAL VASCULAR DISEASE-

CiteScore

4.80

自引率

0.00%

发文量

期刊介绍： Current Hypertension Reviews publishes frontier reviews/ mini-reviews, original research articles and guest edited thematic issues on all the latest advances on hypertension and its related areas e.g. nephrology, clinical care, and therapy. The journal’s aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all clinicians and researchers in the field of hypertension.