Efficacy and Safety of Dual Calcium Channel Blockade for the Treatment of Hypertension: A Meta-Analysis

Alviar, Carlos L.; Devarapally, Santhosh R.; Nadkarni, Girish N.; Romero, Jorge; Benjo, Alexandre; Javed, Fawad; Doherty, Bryan; Kang, Hyunseok; Bangalore, Sripal; Messerli, Franz H.

doi:10.1093/ajh/hps009

Cited by 14 publications

(10 citation statements)

References 31 publications

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“…Patients using minoxidil, in particular, require concomitant use of a β‐blocker to prevent reflex tachycardia, as well as aggressive diuretic use due to minoxidil‐induced sodium retention. Combinations of dihydropyridine and nondihydropyridine CCBs have been used effectively in patients with nonresistant hypertension, generally doubling blood pressure reduction compared with either class alone . However, no studies have prospectively assessed this combination in patients with resistant hypertension.…”

Section: Treatmentmentioning

confidence: 99%

Epidemiology, Prognosis, and Treatment of Resistant Hypertension

Smith

2013

Pharmacotherapy

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Resistant hypertension is a common clinical problem, which, until recently, has received little attention in the medical literature. With this increased attention has come a considerably better understanding of disease epidemiology, prognosis, and treatment, yet much remains unknown. Current data suggest that the prevalence of resistant hypertension has been increasing in recent decades, a concerning finding given that resistant hypertension appears to be associated with a poorer prognosis than nonresistant hypertension. The most appropriate management for these patients has not been fully elucidated, but a multifaceted approach incorporating accurate diagnosis, identification, and removal of substances that interfere with blood pressure, dietary and lifestyle management, and treatment with rational drug combination therapy can be quite effective in controlling blood pressure in these patients. Newer therapies, both pharmacologic and interventional procedures, are under study and may hold promise in the future treatment of resistant hypertension. This review highlights recent research on disease epidemiology and prognosis, and it describes the current body of literature on the treatment of this increasingly common condition.

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Section: Treatmentmentioning

confidence: 99%

Epidemiology, Prognosis, and Treatment of Resistant Hypertension

Smith

2013

Pharmacotherapy

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“…Our findings are more likely related to adjunctive therapy as existing literature has shown no difference 17 or a slight increase in heart rate associated with clevidipine use, 8,[14][15][16]20 which is thought to be due to reflex tachycardia from arteriolar vasodilatation. The negative chronotropic effect of dihydropyridines is known to be negligible, even when combined with agents known to slow heart rate and conduction through the AC node, such as beta-blockers or non-dihydropyridine CCBs 22 which is usually done for the treatment of AAS. Interestingly, although the number of patients in our cohort with low ejection fraction was small, the similar hemodynamic response in these patients when compared to patients with normal ejection fraction, suggests that clevidipine might be safely tolerated in patients with systolic dysfunction, and supports prior data on the use of intravenous nicardipine in patients with low ejection fraction.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clevidipine as a therapeutic and cost-effective alternative to sodium nitroprusside in patients with acute aortic syndromes

Alviar

Gutiérrez

Cho

et al. 2020

European Heart Journal. Acute Cardiovascular Care

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“…In addition, the use of dual calcium channel blockers (dihydropyridine and nondihydropyridine) and mineralocorticoid receptor antagonists (spironolactone and eplerenone) have been proposed when existing multidrug regimens were inadequate to control hypertension. 38,39 Management strategies should be on an individual basis, with the primary aim of blood pressure control but using fewer medications and a regimen that minimizes adverse effects.…”

Section: E8mentioning

confidence: 99%

Atherosclerotic Renal Artery Stenosis and Hypertension: Pragmatism, Pitfalls, and Perspectives

Bavishi

Leeuw

Messerli

2016

The American Journal of Medicine

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For many years and even decades, a diagnostic work-up to look for a secondary form of hypertension, particularly of renovascular origin, has been a central tenet in medicine. Atherosclerotic renal artery stenosis is considered the most common cause of renovascular hypertension. However, advances in understanding the complex pathophysiology of this condition and the recently documented futility of renal revascularization bring into question whether atherosclerotic renal artery stenosis truly causes "renovascular hypertension." From a clinical point of view, a clear distinction should be made between hypertension associated with atherosclerotic renal artery stenosis and hypertension caused by renal artery stenosis-induced activation of the renin-angiotensin-aldosterone system. Most patients with atherosclerotic renal artery stenosis do not have a form of hypertension that is remediable or improved by angioplasty; to expose them to the cost, inconvenience, and risk of a diagnostic work-up add up to little more than a wild goose chase. However, with very few exceptions, medical therapy with antihypertensives and statins remains the cornerstone for the management of patients with atherosclerotic renal artery stenosis and hypertension.

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Efficacy and Safety of Dual Calcium Channel Blockade for the Treatment of Hypertension: A Meta-Analysis

Cited by 14 publications

References 31 publications

Epidemiology, Prognosis, and Treatment of Resistant Hypertension

Epidemiology, Prognosis, and Treatment of Resistant Hypertension

Clevidipine as a therapeutic and cost-effective alternative to sodium nitroprusside in patients with acute aortic syndromes

Atherosclerotic Renal Artery Stenosis and Hypertension: Pragmatism, Pitfalls, and Perspectives

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