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Cardio classics revisited: focus on the role of amlodipine.

Owen AJ, Reid CM - Integr Blood Press Control (2012)

Bottom Line: Amlodipine is a long-acting, dihydropyridine calcium antagonist now widely used for lowering of elevated blood pressure.In recent years it has been shown to be effective in reducing both blood pressure and risk of cardiovascular (CV) events when used in combination with other antihypertensive agents of different classes.Strong evidence of cardiovascular benefit has been attained for combination of amlodipine with diuretics or angiotensin converting enzyme (ACE) inhibitors in a number of high-risk CV groups, including those with established coronary artery disease, diabetes, and at risk of renal disease.

View Article: PubMed Central - PubMed

Affiliation: Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

ABSTRACT
Amlodipine is a long-acting, dihydropyridine calcium antagonist now widely used for lowering of elevated blood pressure. In recent years it has been shown to be effective in reducing both blood pressure and risk of cardiovascular (CV) events when used in combination with other antihypertensive agents of different classes. Strong evidence of cardiovascular benefit has been attained for combination of amlodipine with diuretics or angiotensin converting enzyme (ACE) inhibitors in a number of high-risk CV groups, including those with established coronary artery disease, diabetes, and at risk of renal disease. Combination therapies of amlodipine with other agents eliciting renin-angiotensin-aldosterone system blockade (angiotensin II receptor blockers or renin inhibitors) have been shown to be effective blood pressure-lowering strategies, but await the results of ongoing trials for direct evidence of benefit for renal disease progression and CV morbidity and mortality.

No MeSH data available.


Related in: MedlinePlus

Cumulative event rates in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial).9ALLHAT Research Group. JAMA 2002;288(23):2991. Copyright © (2002) American Medical Association. All rights reserved.
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Related In: Results  -  Collection


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f1-ibpc-5-001: Cumulative event rates in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial).9ALLHAT Research Group. JAMA 2002;288(23):2991. Copyright © (2002) American Medical Association. All rights reserved.

Mentions: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) enrolled 33,357 participants aged over 55 years with hypertension and at least one coronary heart disease (CHD) risk factor in a randomized, double-blind trial comparing three antihypertensive interventions; a calcium antagonist (amlodipine), an angiotensin converting enzyme (ACE)-inhibitor (lisinopril), and a diuretic (chlorthalidone). With a mean follow up of 4.9 years, ALLHAT found no difference in the primary outcome (combined fatal CHD or nonfatal myocardial infarction) between the amlodipine and diuretic groups (relative risk [RR]: 0.98, 95% CI: 0.90–1.07; P = 0.65; Figure 1).9 The size and quality of the ALLHAT trial design provided convincing evidence to refute the suggestions that amlodipine might be inferior in reducing major cardiovascular events, and the lack of any difference between amlodipine and diuretic on the primary outcome was consistent across risk subgroups (based upon age, sex, race, diabetes). However, compared to the thiazide diuretic, amlodipine was associated with an increased 6-year risk of heart failure (RR: 1.38, 95% CI: 1.25–1.52; P < 0.001).9


Cardio classics revisited: focus on the role of amlodipine.

Owen AJ, Reid CM - Integr Blood Press Control (2012)

Cumulative event rates in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial).9ALLHAT Research Group. JAMA 2002;288(23):2991. Copyright © (2002) American Medical Association. All rights reserved.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3278207&req=5

f1-ibpc-5-001: Cumulative event rates in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial).9ALLHAT Research Group. JAMA 2002;288(23):2991. Copyright © (2002) American Medical Association. All rights reserved.
Mentions: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) enrolled 33,357 participants aged over 55 years with hypertension and at least one coronary heart disease (CHD) risk factor in a randomized, double-blind trial comparing three antihypertensive interventions; a calcium antagonist (amlodipine), an angiotensin converting enzyme (ACE)-inhibitor (lisinopril), and a diuretic (chlorthalidone). With a mean follow up of 4.9 years, ALLHAT found no difference in the primary outcome (combined fatal CHD or nonfatal myocardial infarction) between the amlodipine and diuretic groups (relative risk [RR]: 0.98, 95% CI: 0.90–1.07; P = 0.65; Figure 1).9 The size and quality of the ALLHAT trial design provided convincing evidence to refute the suggestions that amlodipine might be inferior in reducing major cardiovascular events, and the lack of any difference between amlodipine and diuretic on the primary outcome was consistent across risk subgroups (based upon age, sex, race, diabetes). However, compared to the thiazide diuretic, amlodipine was associated with an increased 6-year risk of heart failure (RR: 1.38, 95% CI: 1.25–1.52; P < 0.001).9

Bottom Line: Amlodipine is a long-acting, dihydropyridine calcium antagonist now widely used for lowering of elevated blood pressure.In recent years it has been shown to be effective in reducing both blood pressure and risk of cardiovascular (CV) events when used in combination with other antihypertensive agents of different classes.Strong evidence of cardiovascular benefit has been attained for combination of amlodipine with diuretics or angiotensin converting enzyme (ACE) inhibitors in a number of high-risk CV groups, including those with established coronary artery disease, diabetes, and at risk of renal disease.

View Article: PubMed Central - PubMed

Affiliation: Centre of Cardiovascular Research and Education in Therapeutics, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.

ABSTRACT
Amlodipine is a long-acting, dihydropyridine calcium antagonist now widely used for lowering of elevated blood pressure. In recent years it has been shown to be effective in reducing both blood pressure and risk of cardiovascular (CV) events when used in combination with other antihypertensive agents of different classes. Strong evidence of cardiovascular benefit has been attained for combination of amlodipine with diuretics or angiotensin converting enzyme (ACE) inhibitors in a number of high-risk CV groups, including those with established coronary artery disease, diabetes, and at risk of renal disease. Combination therapies of amlodipine with other agents eliciting renin-angiotensin-aldosterone system blockade (angiotensin II receptor blockers or renin inhibitors) have been shown to be effective blood pressure-lowering strategies, but await the results of ongoing trials for direct evidence of benefit for renal disease progression and CV morbidity and mortality.

No MeSH data available.


Related in: MedlinePlus