COMPARISON OF CALCIUM CHANNEL BLOCKERS VERSUS OTHER CLASSES OF ANTIHYPERTENSIVE DRUGS ON BLOOD PRESSURE VARIABILITY IN HYPERTENSIVE PATIENTS IN CHINA- A RETROSPECTIVE PROPENSITY SCORE-MATCHED ANALYSIS

Author(s)

Zhang L1, Yang J1, Li L2, Liu D3, Xie X3, Dong P3, Lin Y2
1Beijing TongRen Hospital, Capital Medical University, Beijing, China, 2PalanDataRx, Shanghai, China, 3Pfizer Investment Co., Ltd., Beijing, China

OBJECTIVES:  Previous studies suggested that blood pressure variability (BPV) was an important risk factor for stroke, coronary heart disease and all-cause mortality. This study aimed to assess the effect of calcium channel blockers (CCBs) versus other classes of antihypertensive drugs on BPV, including angiotensin-I receptor blockers (ARBs), angiotensin-converting-enzyme inhibitors (ACEIs), beta blockers (BB) and diuretic (DI). METHODS:  A retrospective propensity score-matched (PSM) analysis was conducted, which retrieved 5,627 hypertensive inpatients encounter data (with median age at 69 years old, 51% was female, diastolic blood pressure (DBP) ≥40 mmHg and <150 mmHg, systolic blood pressure (SBP) ≥70 mmHg and <260 mmHg), who took at least one antihypertensive agent and completed at least three SBP measurements during the visit. International Classification of Diseases (ICD-10) was used to identify the hypertensive patients. BPV was calculated with standard deviation of SBP during a single inpatient visit. The PSM was used to balance the cohort of patients prescribed CCBs or other classes of antihypertensive drugs. Series of appropriate statistical tests were applied to the PSM sample to examine the different effects on BPV. Additionally, the hypertensive patients with comorbidity i.e. Coronary Artery Disease (CAD), Diabetes Mellitus (DM), Myocardial Infarction (MI), Heart Failure (HF) and Chronic Kidney Disease (CKD) were analysed. RESULTS:  For the hypertensive patients (n=1889, for each cohort), patients prescribed CCBs had lower BPV than patients prescribed other classes of antihypertensive drugs (12.3 mm Hg vs. 12.8 mm Hg, p<0.05). For the hypertensive patients with comorbidity (n=737, for each cohort), patients prescribed CCBs had even lower BPV than patients prescribed other classes of antihypertensive drugs (11.9 mm Hg vs. 12.9 mmHg, p<0.05). CONCLUSIONS:  CCBs was associated with lower BPV than other classes of antihypertensive drugs for the hypertensive patients, and much lower BPV was associated for the hypertensive patients with comorbidity.

Conference/Value in Health Info

2017-05, ISPOR 2017, Boston, MA, USA

Value in Health, Vol. 20, No. 5 (May 2017)

Code

PCV15

Topic

Clinical Outcomes

Topic Subcategory

Comparative Effectiveness or Efficacy

Disease

Cardiovascular Disorders

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