Abstract 3397: Do Calcium Channel Blockers Increase Heart Failure in Patients With Hypertension? A Systematic Review.
Background: Calcium channel blockers (CCB) are widely used to treat hypertension. Proper control of hypertension reduces incident heart failure. Despite similar reductions in blood pressure as compared to other agents, CCB have been suggested to increase heart failure. We carried out a systematic review to investigate this hypothesis.
Methods: Electronic search of the literature using MEDLINE through PubMed, EMBASE, Cochrane collaboration database and abstracts from major cardiology congresses (American College of Cardiology, American Heart Association, European Society of Cardiology and Canadian Cardiovascular Congress). Eligibility criteria were randomized trials with more than 200 patients with hypertension in which CCB’s were compared to active control, and availability of data on the incidence of heart failure. Two independent reviewers were involved in selecting and grading the quality of the manuscripts according to Jadad’s score system. RevMan 4.2.10 software was used for statistical analysis with Mantel-Hantzel fixed and Der-Simonian random effects model.
Results: Seven trials were included in the analysis with a total of 75,209 patients with 2,236 total events. Test for heterogeneity was non-significant with p = 0.23. The OR for incident heart failure when CCB’s were compared to all other antihypertensive therapies was 1.30 (95%CI 1.16–1.46), p<0.00001.
Conclusion: The use of calcium channel blockers to treat hypertension increases the diagnosis of heart failure. Physicians should be aware of this effect when choosing antihyperternsive therapies. Further research should explore and generate potential mechanistic hypothesis.