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Seryapina AA, Malyavko AA, Polityko YK, Yanshole LV, Tsentalovich YP, Markel AL. Metabolic profile of blood serum in experimental arterial hypertension. Vavilovskii Zhurnal Genet Selektsii 2023; 27:530-538. [PMID: 37867609 PMCID: PMC10587007 DOI: 10.18699/vjgb-23-64] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 10/24/2023] Open
Abstract
The etiology of essential hypertension is intricate, since it employs simultaneously various body systems related to the regulation of blood pressure in one way or another: the sympathetic nervous system, renin-angiotensin-aldosterone and hypothalamic-pituitary-adrenal systems, renal and endothelial mechanisms. The pathogenesis of hypertension is influenced by a variety of both genetic and environmental factors, which determines the heterogeneity of the disease in human population. Hence, there is a need to perform research on experimental models - inbred animal strains, one of them being ISIAH rat strain, which is designed to simulate inherited stress-induced arterial hypertension as close as possible to primary (or essential) hypertension in humans. To determine specific markers of diseases, various omics technologies are applied, including metabolomics, which makes it possible to evaluate the content of low-molecular compounds - amino acids, lipids, carbohydrates, nucleic acids fragments - in biological samples available for clinical analysis (blood and urine). We analyzed the metabolic profile of the blood serum of male ISIAH rats with a genetic stress-dependent form of arterial hypertension in comparison with the normotensive WAG rats. Using the method of nuclear magnetic resonance spectroscopy (NMR spectroscopy), 56 metabolites in blood serum samples were identified, 18 of which were shown to have significant interstrain differences in serum concentrations. Statistical analysis of the data obtained showed that the hypertensive status of ISIAH rats is characterized by increased concentrations of leucine, isoleucine, valine, myo-inositol, isobutyrate, glutamate, glutamine, ornithine and creatine phosphate, and reduced concentrations of 2-hydroxyisobutyrate, betaine, tyrosine and tryptophan. Such a ratio of the metabolite concentrations is associated with changes in the regulation of glucose metabolism (metabolic markers - leucine, isoleucine, valine, myo-inositol), of nitric oxide synthesis (ornithine) and catecholamine pathway (tyrosine), and with inflammatory processes (metabolic markers - betaine, tryptophan), all of these changes being typical for hypertensive status. Thus, metabolic profiling of the stress-dependent form of arterial hypertension seems to be an important result for a personalized approach to the prevention and treatment of hypertensive disease.
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Affiliation(s)
- A A Seryapina
- Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - A A Malyavko
- Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Yu K Polityko
- Institute of Cytology and Genetics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - L V Yanshole
- International Tomography Center of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - Yu P Tsentalovich
- International Tomography Center of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
| | - A L Markel
- Novosibirsk State University, Novosibirsk, Russia
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Liu C, Xu J, Liu R, Wang M, Zhuo Y, Su L, Yan H, Zhang Q. Identifying drug-related attributes to personalise antihypertensive agents: the outcome report of patients receiving metoprolol therapy. BMC Med Inform Decis Mak 2021; 21:370. [PMID: 34969399 PMCID: PMC8717677 DOI: 10.1186/s12911-021-01739-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 12/23/2021] [Indexed: 02/08/2023] Open
Abstract
Background Currently, numerous antihypertensive drugs from different pharmacological classes are available; however, blood pressure control is achieved in only less than a third of patients treated for hypertension. Moreover, providing optimal and personalised treatment for hypertension is challenging. Therefore, in this study, we propose a ‘drug-related attributes’ sensitive spectrum. This novel concept can assist clinicians in selecting an optimal antihypertensive drug and improve blood pressure control after examining the attributes of a patient. Methods We collected clinical data on attributes related to hypertension and its therapy of inpatients from West China Hospital who received metoprolol therapy and constructed the sensitive spectrum using data-visualisation tools. Results Our analysis revealed that haematocrit, haemoglobin, serum creatinine, serum cystatin C, serum urea, age, sex, systolic pressure, diastolic pressure, pulse pressure, and heart rate are metoprolol-related attributes. Conclusion Our study showed that all metoprolol-related attributes identified are reasonable and helpful in improving the personalisation of metoprolol therapy. The proposed drug-related attributes spectrum can help personalise antihypertensive medication. Moreover, data-visualisation tools can be effectively used to mine the drug-related attributes sensitive spectrum.
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Affiliation(s)
- Chunyu Liu
- Pharmacy Department, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
| | - Jing Xu
- Pharmacy Department, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Ran Liu
- Information Technology Department, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Miye Wang
- Information Technology Department, West China Hospital, Chengdu, 610041, Sichuan, China
| | - Yixuan Zhuo
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610061, Sichuan, China
| | - Lan Su
- Pharmacy Department, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Hongmei Yan
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, 610061, Sichuan, China.
| | - Qing Zhang
- Cardiovascular Department, West China Hospital, Chengdu, 610041, Sichuan, China
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Jujic A, Matthes F, Vanherle L, Petzka H, Orho-Melander M, Nilsson PM, Magnusson M, Meissner A. Plasma S1P (Sphingosine-1-Phosphate) Links to Hypertension and Biomarkers of Inflammation and Cardiovascular Disease: Findings From a Translational Investigation. Hypertension 2021; 78:195-209. [PMID: 33993723 DOI: 10.1161/hypertensionaha.120.17379] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Amra Jujic
- Department of Clinical Sciences (A.J., M.O.-M., P.M.N., M.M.), Lund University, Malmö, Sweden
- Wallenberg Centre for Molecular Medicine (A.J., F.M., L.V., M.M., A.M.), Lund University, Malmö, Sweden
- Lund University Diabetes Centre (A.J.), Lund University, Malmö, Sweden
| | - Frank Matthes
- Wallenberg Centre for Molecular Medicine (A.J., F.M., L.V., M.M., A.M.), Lund University, Malmö, Sweden
- Department of Experimental Medical Sciences (F.M., L.V., A.M.), Lund University, Malmö, Sweden
| | - Lotte Vanherle
- Wallenberg Centre for Molecular Medicine (A.J., F.M., L.V., M.M., A.M.), Lund University, Malmö, Sweden
- Department of Experimental Medical Sciences (F.M., L.V., A.M.), Lund University, Malmö, Sweden
| | - Henning Petzka
- Department of Mathematics, Lund Technical University, Sweden (H.P.)
| | - Marju Orho-Melander
- Department of Clinical Sciences (A.J., M.O.-M., P.M.N., M.M.), Lund University, Malmö, Sweden
| | - Peter M Nilsson
- Department of Clinical Sciences (A.J., M.O.-M., P.M.N., M.M.), Lund University, Malmö, Sweden
- Department of Internal Medicine, Clinical Research Unit, Malmö, Sweden (P.M.N.)
| | - Martin Magnusson
- Department of Clinical Sciences (A.J., M.O.-M., P.M.N., M.M.), Lund University, Malmö, Sweden
- Wallenberg Centre for Molecular Medicine (A.J., F.M., L.V., M.M., A.M.), Lund University, Malmö, Sweden
- Hypertension in Africa Research Team, North West University Potchefstroom, South Africa (M.M.)
- Department of Cardiology, Skåne University Hospital, Malmö, Sweden (M.M.)
| | - Anja Meissner
- Department of Clinical Sciences (A.J., M.O.-M., P.M.N., M.M.), Lund University, Malmö, Sweden
- Department of Experimental Medical Sciences (F.M., L.V., A.M.), Lund University, Malmö, Sweden
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Effect of Lifestyle Factors on Hypertension by Constitution Type: A Large Community-Based Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019. [DOI: 10.1155/2019/3231628] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background. The risk of hypertension differs according to lifestyle factors and individual constitution types. The aim of this study was to investigate the effect of lifestyle factors on hypertension and to assess whether those effects differ according to the constitution types. Methods. A total of 5,793 men and women were recruited between 2012 and 2014. Odds ratios for hypertension associated with constitution types and lifestyle factors were estimated. Lifestyle factors included smoking status, body mass index, alcohol consumption, physical activity, and sleep quality. Constitution types were estimated based on the Sasang constitutional medicine as the TE type, SE type, and SY type. Results. The risk of hypertension was significantly higher for SY (odds ratio 1.25 (95% confidence interval 1.03 to 1.52) and TE types (1.38 (1.10 to 1.74)) than the SE type even with adjustment of health behaviors. Compared with individuals who had an unhealthy lifestyle, those with healthy lifestyle scores showed significantly lower risk of hypertension in only SY (odds ratio 0.62 (95% confidence interval 0.48 to 0.81)) and TE types (0.69 (0.58 to 0.81)). The difference in risk for hypertension among constitution types was decreased with a healthy lifestyle (1.34 in SY and 2.35 in TE types, as compared with the SE type) versus an unhealthy lifestyle (2.21 in SY and 3.64 in TE types, as compared with the SE type). Conclusion. The risk of hypertension was different by Sasang constitution types. The impact of lifestyle factors differed according to Sasang constitution types, and the difference in risk of hypertension among constitution types was decreased with a healthy lifestyle.
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Ritz C, Astrup A, Larsen TM, Hjorth MF. Weight loss at your fingertips: personalized nutrition with fasting glucose and insulin using a novel statistical approach. Eur J Clin Nutr 2019; 73:1529-1535. [DOI: 10.1038/s41430-019-0423-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 01/09/2023]
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Abstract
PURPOSE OF REVIEW The purpose of this review is to discuss the implications of personalized medicine for the treatment of hypertension, including resistant hypertension. RECENT FINDINGS We suggest a framework for the personalized treatment of hypertension based on the concept of a trade-off between simplicity and personalization. This framework is based on treatment strategies classified as low, medium, or high information burden personalization approaches. The extent to which a higher information burden is justified depends on the clinical scenario, particularly the ease with which the blood pressure can be controlled. A one-size-fits-many treatment strategy for hypertension is efficacious for most people; however, a more personalized approach could be useful in patients with subtypes of hypertension that do not respond as expected to treatment. Clinicians seeing patients with unusual hypertension phenotypes should be familiar with emerging trends in personalized treatment of hypertension.
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Affiliation(s)
- Sarah Melville
- CardioVascular Research New Brunswick, Saint John Regional Hospital, HHN, Saint John, Canada
- IMPART Investigator Team Canada, Saint John, New Brunswick, Canada
| | - James Brian Byrd
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan Medical School, 5570C MSRB II, 1150 West Medical Center Drive, SPC 5678, Ann Arbor, MI, 48109-5678, USA.
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Singh DB. The Impact of Pharmacogenomics in Personalized Medicine. ADVANCES IN BIOCHEMICAL ENGINEERING/BIOTECHNOLOGY 2019; 171:369-394. [PMID: 31485703 DOI: 10.1007/10_2019_110] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Recent advances in Pharmacogenomics have made it possible to understand the reasons behind the different response of a drug. Discovery of genetic variants and its association with the varying response of drug provide the basis for recommending a drug and its dose to an individual patient. Genetic makeup-based prescription, design, and implementation of therapy not only improve the outcome of treatments but also reduce the risk of toxicity and other adverse effects. A better understanding of individual variations and their effect on drug response, metabolism excretion, and toxicity will replace the trial-and-error approach of treatment. Evidence of the clinical utility of pharmacogenetics testing is only available for a few medications, and FDA labels only require pharmacogenetics testing for a small number of drugs. Although there is a great promise, there are not many examples where Pharmacogenomics impacts clinical utility. Some genetic variants related to different diseases have been reported, and many have not been studied yet. The information related to the outcome of treatment with a particular drug and a genetic variant can be used to release a warning/label for the use of that drug. There are many limitations in the way of implementing the goal of personalized medicine. Future advances in the field of genomics, diagnosis approaches, data analysis, clinical decision-making, and sustainable business model for personalization of therapy can speed up the individualization of therapy based on genetic makeup.
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Affiliation(s)
- Dev Bukhsh Singh
- Department of Biotechnology, Institute of Biosciences and Biotechnology, Chhatrapati Shahu Ji Maharaj University, Kanpur, Uttar Pradesh, India.
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Hjorth MF, Zohar Y, Hill JO, Astrup A. Personalized Dietary Management of Overweight and Obesity Based on Measures of Insulin and Glucose. Annu Rev Nutr 2018; 38:245-272. [PMID: 29856931 DOI: 10.1146/annurev-nutr-082117-051606] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
During the past several decades, numerous trials have compared various diets for the management of overweight and obesity, assuming that a single dietary strategy would be appropriate for all individuals. These studies have failed to provide strong evidence for the efficacy of any particular diet, and it is likely that different people will have different levels of success on different diets. We identified studies investigating pretreatment glycemia or insulinemia status, or both, of the individual as prognostic markers of weight loss during periods in which the composition of a participant's diet was known. Overall, research suggests that providing specific diets for weight management based on pretreatment glycemia and insulinemia statuses holds great promise for advancing personalized nutrition.
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Affiliation(s)
- Mads F Hjorth
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, 1958 Frederiksberg C, Denmark; ,
| | | | - James O Hill
- Colorado Nutrition Obesity Research Center, University of Colorado Denver, Aurora, Colorado 80045, USA;
| | - Arne Astrup
- Department of Nutrition, Exercise, and Sports, Faculty of Sciences, University of Copenhagen, 1958 Frederiksberg C, Denmark; ,
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Personalized medicine-a modern approach for the diagnosis and management of hypertension. Clin Sci (Lond) 2017; 131:2671-2685. [PMID: 29109301 PMCID: PMC5736921 DOI: 10.1042/cs20160407] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 09/22/2017] [Accepted: 09/25/2017] [Indexed: 12/15/2022]
Abstract
The main goal of treating hypertension is to reduce blood pressure to physiological levels and thereby prevent risk of cardiovascular disease and hypertension-associated target organ damage. Despite reductions in major risk factors and the availability of a plethora of effective antihypertensive drugs, the control of blood pressure to target values is still poor due to multiple factors including apparent drug resistance and lack of adherence. An explanation for this problem is related to the current reductionist and ‘trial-and-error’ approach in the management of hypertension, as we may oversimplify the complex nature of the disease and not pay enough attention to the heterogeneity of the pathophysiology and clinical presentation of the disorder. Taking into account specific risk factors, genetic phenotype, pharmacokinetic characteristics, and other particular features unique to each patient, would allow a personalized approach to managing the disease. Personalized medicine therefore represents the tailoring of medical approach and treatment to the individual characteristics of each patient and is expected to become the paradigm of future healthcare. The advancement of systems biology research and the rapid development of high-throughput technologies, as well as the characterization of different –omics, have contributed to a shift in modern biological and medical research from traditional hypothesis-driven designs toward data-driven studies and have facilitated the evolution of personalized or precision medicine for chronic diseases such as hypertension.
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Ma L, Han R, Li L, Li Z, Sun F, Diao L, Tang Z. Trends in the prevalence of antihypertensive drug treatment in the Beijing Longitudinal Study of Aging. Arch Gerontol Geriatr 2017; 74:44-48. [PMID: 28957687 DOI: 10.1016/j.archger.2017.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 09/06/2017] [Accepted: 09/15/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE This study aimed to explore the epidemiological characteristics of antihypertensive drug use by community residents in Beijing, China. METHODS Based on well-established statistical sampling techniques such as cluster, stratification, and random selection, 2832, 1828, and 2277 elderly residents aged ≥60 years in Beijing in 2000, 2004, and 2007, respectively, were included. The trend in antihypertensive drug use by elderly patients with hypertension was analyzed. RESULTS The proportion of patients using angiotensin converting enzyme inhibitors (ACEIs) or β-blockers increased, while the proportions of both male and female patients using Chinese single-pill combination decreased. The proportion of relatively young patients using ACEIs or β-blockers increased, as did the proportion of relatively old patients using calcium channel blockers (CCB), ACEIs, or β-blockers. The proportions of both relatively young and relatively old patients using Chinese single-pill combination decreased. The proportion of urban patients using ACEIs, or β-blockers and the proportion of rural patients using CCBs or diuretics increased, while the proportion of both urban and rural patients using Chinese single-pill combination decreased. CONCLUSION During the 7-year study period in Beijing, the proportion of patients using CCBs, ACEIs, diuretics, or β-blockers increased, while the proportion of patients using Chinese single-pill combination decreased. Our results provide important data for the limited evidence on the trend of prevalence of antihypertensive drug used in China.
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Affiliation(s)
- Lina Ma
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Key Laboratory for Neurodegenerative Disease of Ministry of Education, Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China; Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Rui Han
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Key Laboratory for Neurodegenerative Disease of Ministry of Education, Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China; Department of Geriatrics, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Li Li
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Key Laboratory for Neurodegenerative Disease of Ministry of Education, Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China; Department of Geriatrics, Beijing Geriatric Hospital, Beijing, China
| | - Zhenzhen Li
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Key Laboratory for Neurodegenerative Disease of Ministry of Education, Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China; Department of Respiratory, Cangzhou People's Hospital, Cangzhou, China
| | - Fei Sun
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Key Laboratory for Neurodegenerative Disease of Ministry of Education, Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
| | - Lijun Diao
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Key Laboratory for Neurodegenerative Disease of Ministry of Education, Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China
| | - Zhe Tang
- Beijing Geriatric Healthcare Center, Xuanwu Hospital, Capital Medical University, Key Laboratory for Neurodegenerative Disease of Ministry of Education, Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China.
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Hypertension update, JNC8 and beyond. Curr Opin Pharmacol 2017; 33:41-46. [DOI: 10.1016/j.coph.2017.03.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 03/17/2017] [Indexed: 12/27/2022]
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Tran KC, Leung AA, Tang KL, Quan H, Khan NA. Efficacy of Calcium Channel Blockers on Major Cardiovascular Outcomes for the Treatment of Hypertension in Asian Populations: A Meta-analysis. Can J Cardiol 2017; 33:635-643. [PMID: 28377067 DOI: 10.1016/j.cjca.2017.01.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Revised: 01/12/2017] [Accepted: 01/12/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Whether calcium channel blockers exert a greater effect on cardiovascular risk reduction in Asian populations than other antihypertensive agents is unclear. We conducted a meta-analysis of hypertension trials of dihydropyridine calcium channel blockers in Asian populations to clarify this association. METHODS EMBASE, MEDLINE, and Cochrane databases were searched (from inception to August 2016) for randomized controlled trials on cardiovascular death, major adverse cardiovascular events, stroke, congestive heart failure, and coronary revascularization in Asian persons with hypertension. We identified 9 trials that reported data specific to Asian populations (N = 29,643). These trials included 1 placebo-controlled trial and 8 active comparator trials; of these, 5 had angiotensin receptor blockers as the active comparator. RESULTS One placebo-controlled trial (n = 9711) showed significantly reduced cardiovascular mortality, major adverse cardiovascular events, and stroke with calcium channel blockers. Among 8 active comparator trials (n = 19,932), there were no significant differences in mortality (relative risk [RR], 1.10; 95% confidence interval [CI], 0.72-1.67; I2 = 0.0%), major adverse cardiovascular events (RR, 1.02; 95% CI, 0.90-1.15; I2 = 0.0%), stroke (RR, 0.97; 95% CI, 0.80-1.17; I2 = 0.0%), congestive heart failure (RR, 1.01; 95% CI, 0.51-2.00; I2 = 53.7), or coronary revascularization rates (RR, 0.98; 95% CI, 0.76-1.25; I2 = 0.0%) in the calcium channel blocker group compared with other antihypertensive agents. When restricting the meta-analysis to angiotensin receptor blocker comparators (n = 10,384), there were no significant differences in cardiovascular outcomes. CONCLUSIONS There is no evidence that dihydropyridine calcium channel blockers are superior to other antihypertensive agents in Asian populations for the treatment of hypertension.
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Affiliation(s)
- Karen C Tran
- Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Alexander A Leung
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Karen L Tang
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Hude Quan
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Nadia A Khan
- Division of General Internal Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Center for Health Evaluation and Outcome Sciences, Vancouver, British Columbia, Canada
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