Calcium Channel Blockers and the Risk of Exacerbation in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Study of 48,488 Outpatients
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)...
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MDPI AG
2023-07-01
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| Online Access: | https://www.mdpi.com/2227-9059/11/7/1974 |
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| author | Ema Rastoder Pradeesh Sivapalan Josefin Eklöf Imane Achir Alispahic Alexander Svorre Jordan Christian B. Laursen Jørgen Vestbo Christine Jenkins Rune Nielsen Per Bakke Gustavo Fernandez-Romero Daniel Modin Niklas Johansen Filip Soeskov Davidovski Tor Biering-Sørensen Jørn Carlsen Jens Ulrik Stæhr Jensen |
| author_facet | Ema Rastoder Pradeesh Sivapalan Josefin Eklöf Imane Achir Alispahic Alexander Svorre Jordan Christian B. Laursen Jørgen Vestbo Christine Jenkins Rune Nielsen Per Bakke Gustavo Fernandez-Romero Daniel Modin Niklas Johansen Filip Soeskov Davidovski Tor Biering-Sørensen Jørn Carlsen Jens Ulrik Stæhr Jensen |
| author_sort | Ema Rastoder |
| collection | DOAJ |
| description | 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 (<i>n</i> = 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. |
| first_indexed | 2024-03-11T01:16:25Z |
| format | Article |
| id | doaj.art-338dc1297df74d77bb68fc58375d5f87 |
| institution | Directory Open Access Journal |
| issn | 2227-9059 |
| language | English |
| last_indexed | 2024-03-11T01:16:25Z |
| publishDate | 2023-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomedicines |
| spelling | doaj.art-338dc1297df74d77bb68fc58375d5f872023-11-18T18:27:40ZengMDPI AGBiomedicines2227-90592023-07-01117197410.3390/biomedicines11071974Calcium Channel Blockers and the Risk of Exacerbation in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Study of 48,488 OutpatientsEma Rastoder0Pradeesh Sivapalan1Josefin Eklöf2Imane Achir Alispahic3Alexander Svorre Jordan4Christian B. Laursen5Jørgen Vestbo6Christine Jenkins7Rune Nielsen8Per Bakke9Gustavo Fernandez-Romero10Daniel Modin11Niklas Johansen12Filip Soeskov Davidovski13Tor Biering-Sørensen14Jørn Carlsen15Jens Ulrik Stæhr Jensen16Section of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkSection of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkSection of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkSection of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkSection of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkDepartment of Respiratory Medicine, Odense University Hospital, 5000 Odense, DenmarkAllergi-Og Lungeklinikken Vanløse, 2720 Copenhagen, DenmarkDepartment of Thoracic Medicine, Concord Hospital, University of Sydney, Concord, NSW 2139, AustraliaDepartment of Clinical Science, University of Bergen, 5021 Bergen, NorwayDepartment of Thoracic Medicine, Haukeland University Hospital, 5021 Bergen, NorwayDepartment of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19122, USASection of Cardiovascular Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkSection of Cardiovascular Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkSection of Cardiovascular Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkSection of Cardiovascular Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkDepartment of Cardiology, Rigshospitalet, Copenhagen University Hospital, Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, DenmarkSection of Respiratory Medicine, Herlev-Gentofte Hospital, 2900 Hellerup, DenmarkPatients 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 (<i>n</i> = 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.https://www.mdpi.com/2227-9059/11/7/1974COPDcalcium channel blockersthiazideexacerbationsamlodipinebendroflumethiazide |
| spellingShingle | Ema Rastoder Pradeesh Sivapalan Josefin Eklöf Imane Achir Alispahic Alexander Svorre Jordan Christian B. Laursen Jørgen Vestbo Christine Jenkins Rune Nielsen Per Bakke Gustavo Fernandez-Romero Daniel Modin Niklas Johansen Filip Soeskov Davidovski Tor Biering-Sørensen Jørn Carlsen Jens Ulrik Stæhr Jensen Calcium Channel Blockers and the Risk of Exacerbation in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Study of 48,488 Outpatients Biomedicines COPD calcium channel blockers thiazide exacerbations amlodipine bendroflumethiazide |
| title | Calcium Channel Blockers and the Risk of Exacerbation in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Study of 48,488 Outpatients |
| title_full | Calcium Channel Blockers and the Risk of Exacerbation in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Study of 48,488 Outpatients |
| title_fullStr | Calcium Channel Blockers and the Risk of Exacerbation in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Study of 48,488 Outpatients |
| title_full_unstemmed | Calcium Channel Blockers and the Risk of Exacerbation in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Study of 48,488 Outpatients |
| title_short | Calcium Channel Blockers and the Risk of Exacerbation in Patients with Chronic Obstructive Pulmonary Disease: A Nationwide Study of 48,488 Outpatients |
| title_sort | calcium channel blockers and the risk of exacerbation in patients with chronic obstructive pulmonary disease a nationwide study of 48 488 outpatients |
| topic | COPD calcium channel blockers thiazide exacerbations amlodipine bendroflumethiazide |
| url | https://www.mdpi.com/2227-9059/11/7/1974 |
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