Calcium Channel Blockers and the Risk of Exacerbation in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Study of 48,488 Outpatients.

Autor: Rastoder E; Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark., Sivapalan P; Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark., Eklöf J; Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark., Achir Alispahic I; Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark., Jordan AS; Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark., Laursen CB; Department of Respiratory Medicine, Odense University Hospital, 5000 Odense, Denmark.; Odense Respiratory Research Unit (ODIN), Department of Clinical Research, University of South Denmark, 5000 Odense, Denmark., Vestbo J; Allergi-Og Lungeklinikken Vanløse, 2720 Copenhagen, Denmark.; Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester M13 9MT, UK., Jenkins C; Department of Thoracic Medicine, Concord Hospital, University of Sydney, Concord, NSW 2139, Australia., Nielsen R; Department of Clinical Science, University of Bergen, 5021 Bergen, Norway.; Department of Thoracic Medicine, Haukeland University Hospital, 5021 Bergen, Norway., Bakke P; Department of Thoracic Medicine, Haukeland University Hospital, 5021 Bergen, Norway., Fernandez-Romero G; Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19122, USA., Modin D; Section of Cardiovascular Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark., Johansen N; Section of Cardiovascular Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark., Davidovski FS; Section of Cardiovascular Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark., Biering-Sørensen T; Section of Cardiovascular Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark., Carlsen J; Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark., Jensen JUS; Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark.
Jazyk: angličtina
Zdroj: Biomedicines [Biomedicines] 2023 Jul 12; Vol. 11 (7). Date of Electronic Publication: 2023 Jul 12.
DOI: 10.3390/biomedicines11071974
Abstrakt: Patients with chronic obstructive pulmonary disease (COPD) are prone to developing arterial hypertension, and many patients are treated with the calcium channel blocker amlodipine. However, it remains unclear whether using this drug potentially affects the risk of acute severe exacerbations (AECOPD) and all-cause mortality in these patients. The data were collected from Danish national registries, containing complete information on health, prescriptions, hospital admissions, and outpatient clinic visits. The COPD patients ( n = 48,488) were matched via propensity score on known predictors of the primary outcome in an active comparator design. One group was exposed to amlodipine treatment, and the other was exposed to bendroflumethiazide, since both of these drugs are considered to be the first choice for the treatment of arterial hypertension according to Danish guidelines. The use of amlodipine was associated with a reduced risk of death from all causes at the 1-year follow-up (hazard ratio 0.69, 95% confidence interval: 0.62-0.76) compared with the use of bendroflumethiazide in the matched patients. No difference in the risk of severe AECOPD was found. In the COPD patients, amlodipine use was associated with a lower risk of death from all causes compared with the use of bendroflumethiazide. Amlodipine seems to be a safe first choice for the treatment of arterial hypertension in COPD patients.
Databáze: MEDLINE
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