Abstract 2987: Calcium Channel Antagonists Reduce the Risk of Stroke in Patients with Hypertension and Coronary Artery Disease: A Meta-Analysis
Background: Antihypertensives including calcium channel antagonists, have been shown to be very efficacious in lowering BP and reducing the risk of stroke in patients at high risk. However, the role of antihypertensive agents at risk reduction of stroke in patients with hypertension and coronary artery disease (CAD) is not well defined.
Methods: We conducted a MEDLINE, PUBMED, Cochrane search of studies using the terms: calcium channel blockers/antagonist and hypertension. The search was limited to randomized controlled trials in human subjects published in the English language and in patients with hypertension and known CAD reporting stroke as one of the end points were chosen. Of the 1848 studies, only 5 studies fulfilled the inclusion criteria. Only studies using long acting calcium channel antagonists were included in this analysis.
Results: A total of 16,371 patients on calcium channel antagonists were compared against 16, 385 patients on other therapy. The other therapy varied from an angiotensin converting enzyme (CAMELOT, JMIC-B) to beta blocker (INVEST) to a placebo (ACTION, PREVENT). When compared to the other therapy, calcium channel antagonists resulted in a 22% relative risk reduction in stroke (Pooled RR,0.78; 95% CI,0.68 – 0.89; P < 0.0001). There was no heterogeniety in this analysis (Heterogeneity chi-squared = 2.94 ; p = 0.569). There was no publication bias based on either the rank correlation method (Begg’s test) or the weighted regression method (Egger test, P = 0.54).
Conclusions: In patients with hypertension and CAD, long acting calcium channel antagonists results in a 22% relative risk reduction for stroke compared to the other therapy.