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 -