Abstract 5789: Prevention of Peripheral Arterial Disease With Calcium Channel Blockers in Patients With Hypertension: A Meta-analysis of Randomized Trials
Background: Peripheral arterial disease (PAD) is a manifestation of atherosclerosis and associated with increased morbidity and mortality. Several preclinical studies suggest that calcium channel blockers (CCB) may prevent the development of atherosclerosis in high-risk patients.
Aim: This study sought to evaluate the effect of CCB treatment for the primary prevention of PAD in patients with hypertension.
Methods: We searched the published literature (MEDLINE, the Cochrane Central Register of Controlled Trials and EMBASE) for trials published after 1990 reporting the effect of CCB on the development of PAD. Criteria for inclusion included a study duration >6 months, use of a randomized control group not receiving CCB, and availability of outcome data on PAD. We conducted a meta-analysis with random and fixed effects models to combine the results of these studies.
Results: Of 2,006 potentially relevant studies, a total of 7 studies (65,925 patients) met our inclusion criteria. Patients randomized to the control group received either placebo or active treatment with ACE-inhibitors, beta-blockers or diuretics. In patients receiving CCB, 535 of 24,678 (2.2%) developed PAD versus 1,249 of 39,833 (3.1%) in the control group. CCB reduced the relative risk for PAD development by 25% (95% confidence interval 33% to 17%, p<0.001). In the subset of 6 studies with 64,511 participants taking dihydropyridines vs control, dihydropyridines were associated with a significant risk reduction in PAD of 26% (95% CI 33% to 18%, p<0.001).
Conclusion: Based on the results of this study, calcium-channel blockers appear to be effective in the prevention of PAD in patients with hypertension.