TY - JOUR

T1 - Calcium Channel Blockers and the Risk of Exacerbation in Patients with Chronic Obstructive Pulmonary Disease

T2 - A Nationwide Study of 48,488 Outpatients

AU - Rastoder, Ema

AU - Sivapalan, Pradeesh

AU - Eklöf, Josefin

AU - Achir Alispahic, Imane

AU - Jordan, Alexander Svorre

AU - Laursen, Christian B

AU - Vestbo, Jørgen

AU - Jenkins, Christine

AU - Nielsen, Rune

AU - Bakke, Per

AU - Fernandez-Romero, Gustavo

AU - Modin, Daniel

AU - Johansen, Niklas

AU - Davidovski, Filip Soeskov

AU - Biering-Sørensen, Tor

AU - Carlsen, Jørn

AU - Jensen, Jens Ulrik Stæhr

PY - 2023/7/12

Y1 - 2023/7/12

N2 - Patients with chronic obstructive pulmonary disease (COPD) are prone to developing arterial hypertension, and many patients are treated with the calcium channel blocker amlodipine. However, it remains unclear whether using this drug potentially affects the risk of acute severe exacerbations (AECOPD) and all-cause mortality in these patients. The data were collected from Danish national registries, containing complete information on health, prescriptions, hospital admissions, and outpatient clinic visits. The COPD patients (n = 48,488) were matched via propensity score on known predictors of the primary outcome in an active comparator design. One group was exposed to amlodipine treatment, and the other was exposed to bendroflumethiazide, since both of these drugs are considered to be the first choice for the treatment of arterial hypertension according to Danish guidelines. The use of amlodipine was associated with a reduced risk of death from all causes at the 1-year follow-up (hazard ratio 0.69, 95% confidence interval: 0.62-0.76) compared with the use of bendroflumethiazide in the matched patients. No difference in the risk of severe AECOPD was found. In the COPD patients, amlodipine use was associated with a lower risk of death from all causes compared with the use of bendroflumethiazide. Amlodipine seems to be a safe first choice for the treatment of arterial hypertension in COPD patients.

AB - Patients with chronic obstructive pulmonary disease (COPD) are prone to developing arterial hypertension, and many patients are treated with the calcium channel blocker amlodipine. However, it remains unclear whether using this drug potentially affects the risk of acute severe exacerbations (AECOPD) and all-cause mortality in these patients. The data were collected from Danish national registries, containing complete information on health, prescriptions, hospital admissions, and outpatient clinic visits. The COPD patients (n = 48,488) were matched via propensity score on known predictors of the primary outcome in an active comparator design. One group was exposed to amlodipine treatment, and the other was exposed to bendroflumethiazide, since both of these drugs are considered to be the first choice for the treatment of arterial hypertension according to Danish guidelines. The use of amlodipine was associated with a reduced risk of death from all causes at the 1-year follow-up (hazard ratio 0.69, 95% confidence interval: 0.62-0.76) compared with the use of bendroflumethiazide in the matched patients. No difference in the risk of severe AECOPD was found. In the COPD patients, amlodipine use was associated with a lower risk of death from all causes compared with the use of bendroflumethiazide. Amlodipine seems to be a safe first choice for the treatment of arterial hypertension in COPD patients.

U2 - 10.3390/biomedicines11071974

DO - 10.3390/biomedicines11071974

M3 - Journal article

C2 - 37509614

VL - 11

JO - Biomedicines

JF - Biomedicines

SN - 2227-9059

IS - 7

M1 - 1974

ER -