Effects of calcium channel blocker benidipine-based combination therapy on target blood pressure control and cardiovascular outcome: a sub-analysis of the COPE trial

We compared three benidipine-based regimens-that is, benidipine plus angiotensin receptor blocker (ARB), β-blocker (BB) or thiazide-and found that the benidipine-BB combination was less beneficial in reducing the risk of stroke than the benidipine-thiazide combination. This sub-analysis sought to co...

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Published in:Hypertension research 2017-04, Vol.40 (4), p.376-384
Main Authors: Umemoto, Seiji, Ogihara, Toshio, Matsuzaki, Masunori, Rakugi, Hiromi, Ohashi, Yasuo, Saruta, Takao
Format: Article
Language:English
Subjects:
Aged
Antihypertensive Agents - pharmacology
Antihypertensive Agents - therapeutic use
Blood Pressure - drug effects
Blood Pressure Determination
Calcium Channel Blockers - pharmacology
Calcium Channel Blockers - therapeutic use
Dihydropyridines - pharmacology
Dihydropyridines - therapeutic use
Drug Therapy, Combination
Female
Heart Rate - drug effects
Humans
Hypertension - drug therapy
Male
Middle Aged
Original
Sodium Chloride Symporter Inhibitors - pharmacology
Sodium Chloride Symporter Inhibitors - therapeutic use
Treatment Outcome
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container_title Hypertension research
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creator Umemoto, Seiji
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Saruta, Takao
description We compared three benidipine-based regimens-that is, benidipine plus angiotensin receptor blocker (ARB), β-blocker (BB) or thiazide-and found that the benidipine-BB combination was less beneficial in reducing the risk of stroke than the benidipine-thiazide combination. This sub-analysis sought to compare the effects of reaching a target blood pressure (BP) (
doi_str_mv 10.1038/hr.2016.158
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This sub-analysis sought to compare the effects of reaching a target blood pressure (BP) (&lt;140/90 mm Hg) on the cardiovascular outcomes among the three benidipine-based treatment groups in the Combination Therapy of Hypertension to Prevent Cardiovascular Events trial. This sub-analysis included 3001 subjects to evaluate the achievement of target BP at a minimum of three points at 6-month intervals of clinical BP measurements during the study period. After randomization, the patients were categorized into two groups on the basis of achieved on-treatment target BP: a good control (GC) group achieving a BP⩾66.7% of the target and a poor control (PC) group with a BP &lt;66.6% of the target. For each of the two control groups, outcomes were compared among the three treatment groups. The event rates for cardiovascular composite endpoints, stroke and hard cardiovascular events were higher in the PC group than the GC group (P=0.041, P=0.042 and P=0.038, respectively). Within the PC group, hazard ratios for the incidence of cardiovascular events were lower in the benidipine-thiazide group than in the benidipine-BB group (composite cardiovascular events: 2.04, P=0.033; stroke: 4.14, P=0.005; and hard cardiovascular events: 3.52, P=0.009). Within the GC group, the incidence of cardiovascular events was not different among the three treatment regimens. 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Within the PC group, hazard ratios for the incidence of cardiovascular events were lower in the benidipine-thiazide group than in the benidipine-BB group (composite cardiovascular events: 2.04, P=0.033; stroke: 4.14, P=0.005; and hard cardiovascular events: 3.52, P=0.009). Within the GC group, the incidence of cardiovascular events was not different among the three treatment regimens. The benidipine-thiazide combination may provide better cardiovascular outcomes than the benidipine-BB combination even in patients with poor BP control.</abstract><cop>England</cop><pub>Nature Publishing Group</pub><pmid>27904156</pmid><doi>10.1038/hr.2016.158</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Aged
Antihypertensive Agents - pharmacology
Antihypertensive Agents - therapeutic use
Blood Pressure - drug effects
Blood Pressure Determination
Calcium Channel Blockers - pharmacology
Calcium Channel Blockers - therapeutic use
Dihydropyridines - pharmacology
Dihydropyridines - therapeutic use
Drug Therapy, Combination
Female
Heart Rate - drug effects
Humans
Hypertension - drug therapy
Male
Middle Aged
Original
Sodium Chloride Symporter Inhibitors - pharmacology
Sodium Chloride Symporter Inhibitors - therapeutic use
Treatment Outcome
title Effects of calcium channel blocker benidipine-based combination therapy on target blood pressure control and cardiovascular outcome: a sub-analysis of the COPE trial
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