Hydrochlorothiazide Versus Calcium Channel Blockers: What is the Best Add-on to a Renin-Angiotensin System Blocker for Treating Hypertension in Patients with Renal Disease?

2011 ◽  
Vol 13 (5) ◽  
pp. 386-395 ◽  
Author(s):  
Edgar V. Lerma
Keyword(s):  
Renal Disease ◽  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Renin Angiotensin System ◽  
Channel Blockers ◽  
Angiotensin System ◽  
Renin Angiotensin

scholarly journals Rates of delirium associated with calcium channel blockers compared to diuretics, renin-angiotensin system agents and beta-blockers: An electronic health records network study

2020 ◽  
Vol 34 (8) ◽  
pp. 848-855 ◽  
Author(s):  
Paul J Harrison ◽  
Sierra Luciano ◽  
Lucy Colbourne
Keyword(s):  
Calcium Channel ◽  
Antihypertensive Drug ◽  
Calcium Channel Blockers ◽  
Antihypertensive Drugs ◽  
Beta Blockers ◽  
Renin Angiotensin System ◽  
Negative Control ◽  
Channel Blockers ◽  
Angiotensin System ◽  
Renin Angiotensin

Background: Antihypertensive drugs, especially calcium channel blockers, have been associated with differential rates of a number of neuropsychiatric outcomes. Delirium is commonly attributed to medication, including antihypertensive drugs, but delirium incidence has not been compared directly between antihypertensive drug classes. Methods: Using a federated electronic health records network of 25.5 million people aged 50 years or older, we measured rates of delirium over a two-year period in patients prescribed calcium channel blockers compared to the other main antihypertensive drug classes. Extensive propensity score matching was used to create cohorts matched for a range of demographic factors and delirium risk factors. Negative control outcomes were also measured. Results: Cohort sizes ranged from 54,000–577,000. Delirium was more common with calcium channel blockers than with renin-angiotensin system agents (~40% higher) but less common than with beta-blockers (~20% lower). These differences remained when patients with a range of other delirium risk factors were excluded, and they were not paralleled by the negative control outcomes. Comparisons between calcium channel blockers and diuretics produced inconclusive results. Conclusions: Calcium channel blockers are associated with higher rates of delirium than renin-angiotensin system agents, but lower rates compared to beta-blockers. The findings add to the list of factors which may be considered when choosing antihypertensive drug class.

scholarly journals Risk of Developing Hypokalemia in Patients With Hypertension Treated With Combination Antihypertensive Therapy

Hypertension ◽  
2020 ◽  
Vol 75 (4) ◽  
pp. 966-972 ◽  
Author(s):  
Maria Lukács Krogager ◽  
Rikke Nørmark Mortensen ◽  
Peter Enemark Lund ◽  
Henrik Bøggild ◽  
Steen Møller Hansen ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Calcium Channel ◽  
Antihypertensive Therapy ◽  
Calcium Channel Blockers ◽  
Odds Ratio ◽  
Renin Angiotensin System ◽  
Channel Blockers ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Β Blockers

Little is known about the occurrence of hypokalemia due to combination therapy for hypertension. Using data from Danish administrative registries, we investigated the association between different combinations of antihypertensive therapy and risk of developing hypokalemia. Using incidence density matching, 2 patients without hypokalemia were matched to a patient with hypokalemia (K, <3.5 mmol/L) on age, sex, renal function, and time between index date and date of potassium measurement. Combination therapies were subdivided into 10 groups including β-blockers (BB)+thiazides (BB+thiazides), calcium channel blockers (CCB)+renin angiotensin system inhibitors (RASi)+thiazides (CCB+RASi+Thiazides), calcium channel blockers+thiazides (CCB+thiazides), and β-blockers+renin angiotensin system inhibitors+thiazides (BB+RASi+thiazides). We used conditional logistic regression to estimate the odds of developing hypokalemia for different combinations of antihypertensive drugs within 90 days of combination therapy initiation. We matched 463 patients with hypokalemia to 926 patients with normal potassium concentrations. The multivariable analysis showed 5.82× increased odds of developing hypokalemia if administered CCB+thiazides (95% CI, 3.06–11.08) compared with CCB+RASi. Other combinations significantly associated with increased hypokalemia odds were BB+thiazides (odds ratio, 3.34 [95% CI, 1.67–6.66]), CCB+RASi+thiazides (odds ratio, 3.07 [95% CI, 1.72–5.46]), and BB+RASi+thiazides (odds ratio, 2.78 [95% CI, 1.41–5.47]). Combinations of thiazides with CCB, RASi, or BB were strongly associated with increased hypokalemia risk within 90 days of treatment initiation.

1013 DIFFERENT EFFECT BETWEEN RENIN-ANGIOTENSIN SYSTEM INHIBITORS AND CALCIUM CHANNEL BLOCKERS IN HYPERTENSIVE PATIENTS

2012 ◽  
Vol 30 ◽  
pp. e294
Author(s):  
Hiroyuki Takase ◽  
Yasuaki Dohi ◽  
Tateo Okado ◽  
Takamitsu Tanaka ◽  
Tomomi Hashimoto ◽  
...  
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Renin Angiotensin System ◽  
Channel Blockers ◽  
Angiotensin System ◽  
Hypertensive Patients ◽  
Renin Angiotensin

scholarly journals Fixed-Dose Combinations of Renin–Angiotensin System Inhibitors and Calcium Channel Blockers in the Treatment of Hypertension

Medicine ◽  
2015 ◽  
Vol 94 (51) ◽  
pp. e2355 ◽  
Author(s):  
Fu-Chih Hsiao ◽  
Ying-Chang Tung ◽  
Shing-Hsien Chou ◽  
Lung-Sheng Wu ◽  
Chia-Pin Lin ◽  
...  
Keyword(s):  
Calcium Channel ◽  
Calcium Channel Blockers ◽  
Renin Angiotensin System ◽  
Fixed Dose ◽  
Channel Blockers ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Treatment Of Hypertension
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