EPICORE Centre, Division of Cardiology, University of Alberta, Edmonton, Alberta, Canada.
Am J Cardiol. 2010 Jul 15;106(2):228-35. doi: 10.1016/j.amjcard.2010.02.031.
Calcium channel blockers (CCBs) are widely used to control hypertension. Previous work suggested that their use could increase heart failure (HF), which is 1 of the consequences of uncontrolled hypertension. Information about the effect of CCBs on incident HF in patients with hypertension is scarce. A systematic review was conducted to evaluate patients with hypertension treated with CCBs and incident HF. An electronic search of publications was conducted using 8 major databases. Studies were eligible if they (1) were randomized clinical trials, (2) performed comparisons of CCBs versus active control, (3) randomized >200 patients, (4) had follow-up periods >6 months, and (5) provided data regarding incident HF. Trials of renal transplantation patients, placebo-controlled trials, and HF trials were excluded. A total of 156,766 patients were randomized to CCBs or control, with a total of 5,049 events. The analysis indicated a significant increase in the diagnosis of HF in patients allocated to CCBs (odds ratio 1.18, 95% confidence interval 1.07 to 1.31). The effect observed was independent of incident myocardial infarction. Subgroup analyses indicated that patients with diabetes were at higher risk for developing HF (odds ratio 1.71, 95% confidence interval 1.21 to 2.41). In conclusion, the results suggest that patients with hypertension treated with CCBs have increased incident HF.
钙通道阻滞剂（CCBs）被广泛用于控制高血压。先前的研究表明，它们的使用可能会增加心力衰竭（HF）的风险，而心力衰竭是高血压失控的后果之一。关于高血压患者使用 CCBs 对心力衰竭事件发生率的影响的信息很少。进行了一项系统评价，以评估接受 CCBs 治疗的高血压患者的心力衰竭事件发生率。使用 8 个主要数据库对出版物进行了电子检索。符合条件的研究包括：（1）随机临床试验；（2）CCBs 与活性对照的比较；（3）随机分组>200 名患者；（4）随访时间>6 个月；（5）提供关于心力衰竭事件发生率的数据。排除了肾移植患者的试验、安慰剂对照试验和心力衰竭试验。共有 156766 名患者被随机分配到 CCBs 或对照组，共有 5049 例事件。分析表明，接受 CCBs 治疗的患者心力衰竭的诊断显著增加（比值比 1.18，95%置信区间 1.07 至 1.31）。观察到的效果独立于心肌梗死的发生。亚组分析表明，患有糖尿病的患者发生心力衰竭的风险更高（比值比 1.71，95%置信区间 1.21 至 2.41）。总之，结果表明，接受 CCBs 治疗的高血压患者心力衰竭事件发生率增加。
