Calcium channel blockers effective against peripheral artery disease in hypertensives

Calcium channel blockers (CCBs) strongly suppress peripheral artery disease (PAD) in patients with hypertension, reports a new meta-analysis.

Accessing the databases of PubMed and the Cochrane registry, researchers retrieved seven randomized controlled trials corresponding to 71,971 patients who were followed for 3.8 years. Patients who were on CCB medication comprised the intervention group, while controls were given either placebo or active treatment with any other antihypertensive agent.

Of the 27,502 patients who were on CCBs, only 547 developed PAD, corresponding to a rate of 2 percent. In the 42,659 controls, 1,263 PAD cases were reported, with a rate of 3 percent. Pooled analysis found that CCBs significantly reduced the risk of PAD (odds ratio [OR], 0.70, 95 percent confidence interval [CI], 0.58–0.86; p=0.0005).

The findings were robust to sensitivity analyses. For instance, excluding studies where the mean blood pressure was significantly different between the two groups at the end of the study did not alter the principal findings (OR, 0.58, 95 percent CI, 0.45–0.74; p<0.0001).

The same was true when analysis was restricted to six studies in which CCBs were compared against active, antihypertensive treatment (OR, 0.71, 95 percent CI, 0.56–0.89; p=0.004).

CCBs were also significantly effective against secondary outcomes, such as all-cause mortality and nonfatal stroke, relative to placebo or active treatment. No such effects were reported for cardiovascular mortality, nonfatal myocardial infarction and congestive heart failure.

Several limitations were noted, including the heterogeneity in the definition of PAD and limited sample sizes. Future trials are needed to confirm the present findings, the researchers noted.