Efficacy and Safety of Azelnidipine as an Antihypertensive Compared to Amlodipine: A Systematic Review and Meta-analysis.

IF 3.1 Q2 PERIPHERAL VASCULAR DISEASE

High Blood Pressure & Cardiovascular Prevention Pub Date : 2023-09-01 Epub Date: 2023-09-28 DOI:10.1007/s40292-023-00601-5

Debkumar Pal, Shampa Maji, Rituparna Maiti

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引用次数: 0

Abstract

Introduction: Azelnidipine is one of the newer Calcium Channel Blockers (CCB) approved in China, Japan, and India. Some studies have found that the blood pressure-lowering effect of azelnidipine is more than amlodipine, and others found the effect similar.

Aim: This meta-analysis was conducted to evaluate the efficacy of azelnidipine in managing hypertensive patients by lowering Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), and Heart Rate (HR) as compared to amlodipine.

Methods: PubMed/MEDLINE, Google Scholar, PROQUEST, and International Clinical Trial Registry Platform (ICTRP) were searched for published articles to evaluate the clinical efficacy of azelnidipine in the management of hypertension patients. Data were extracted from the selected 11 randomized clinical trials (RCTs). The risk of bias 2 (RoB2) tool was used for the quality assessment of the included studies, and the random-effects model was used to estimate the effect size.

Results: There were no statistically significant differences in the reduction of SBP (Mean Difference, MD: - 1.07; 95% CI: - 4.10, 1.95, p-value: 0.49) and DBP (MD: 0.27; 95% CI: - 2.66, 3.20, p-value: 0.86) between both the drugs. In terms of HR reduction, there was a statistically significant difference (MD: - 3.63; 95% CI: - 5.27, - 2.00, p-value: < 0.0001) between both drugs. Egger's test excluded any publication bias for the included studies (p = 0.21). Meta-regression excluded the effect of the duration of treatment on outcome parameters.

Conclusion: Though no significant difference between azelnidipine and amlodipine was found, in terms of reduction in SBP and DBP, azelnidipine reduced heart rate significantly compared to amlodipine.

Prospero registration: CRD42023390361.

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与氨氯地平相比，阿泽尼地平降压的有效性和安全性：系统评价和荟萃分析。

简介：阿泽尼地平是中国、日本和印度批准的新型钙通道阻滞剂之一。一些研究发现，阿泽尼地平的降压作用比氨氯地平更大，另一些研究发现效果相似。目的：本荟萃分析旨在评估与氨氯地平相比，阿泽尼地平通过降低收缩压（SBP）、舒张压（DBP）和心率（HR）来治疗高血压患者的疗效。方法：检索PubMed/MEDLINE、Google Scholar、PROQUEST和国际临床试验注册平台（ICTRP）发表的文章，评价阿泽尼地平治疗高血压患者的临床疗效。数据取自选定的11项随机临床试验（RCT）。偏倚风险2（RoB2）工具用于纳入研究的质量评估，随机效应模型用于估计效应大小。结果：SBP的降低没有统计学上的显著差异（平均差异，MD：- 1.07；95%CI：- 4.10，1.95，p值：0.49）和DBP（MD:0.27；95%置信区间：- 2.66,3.20，p值：0.86）。在HR降低方面，存在统计学显著差异（MD：- 3.63；95%CI：- 5.27- 2.00，p值：结论：虽然阿泽尼地平和氨氯地平之间没有显著差异，但在SBP和DBP的降低方面，阿泽尼平与氨氯地平相比显著降低了心率。Prospero注册号：CRD42023390361。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

High Blood Pressure & Cardiovascular Prevention PERIPHERAL VASCULAR DISEASE-

CiteScore

5.70

自引率

3.30%

发文量

期刊介绍： High Blood Pressure & Cardiovascular Prevention promotes knowledge, update and discussion in the field of hypertension and cardiovascular disease prevention, by providing a regular programme of independent review articles covering key aspects of the management of hypertension and cardiovascular diseases. The journal includes: Invited ''State of the Art'' reviews. Expert commentaries on guidelines, major trials, technical advances.Presentation of new intervention trials design.''Pros and Cons'' or round tables on controversial issues.Statements on guidelines from hypertension and cardiovascular scientific societies.Socio-economic issues.Cost/benefit in prevention of cardiovascular diseases.Monitoring of healthcare systems.News and views from the Italian Society of Hypertension (including abstracts).All manuscripts are subject to peer review by international experts. Letters to the editor are welcomed and will be considered for publication.