Yamamoto Ko, Takeji Yasuaki, Taniguchi Tomohiko, Morimoto Takeshi, Shirai Shinichi, Kitai Takeshi, Tabata Hiroyuki, Ohno Nobuhisa, Murai Ryosuke, Osakada Kohei, Murata Koichiro, Nakai Masanao, Tsuneyoshi Hiroshi, Tada Tomohisa, Amano Masashi, Watanabe Shin, Shiomi Hiroki, Watanabe Hirotoshi, Yoshikawa Yusuke, Nishikawa Ryusuke, Obayashi Yuki, Toyofuku Mamoru, Tatsushima Shojiro, Kanamori Norio, Miyake Makoto, Nakayama Hiroyuki, Nagao Kazuya, Izuhara Masayasu, Nakatsuma Kenji, Inoko Moriaki, Fujita Takanari, Kimura Masahiro, Ishii Mitsuru, Usami Shunsuke, Nakazeki Fumiko, Togi Kiyonori, Inuzuka Yasutaka, Ando Kenji, Komiya Tatsuhiko, Ono Koh, Minatoya Kenji, Kimura Takeshi
Department of Cardiology, Kokura Memorial Hospital.
Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences.
Circ J. 2025 Aug 25;89(9):1528-1537. doi: 10.1253/circj.CJ-24-0771. Epub 2024 Dec 18.
There is a paucity of data on safety of calcium channel blockers (CCB) in patients with severe aortic stenosis (AS) and hypertension.
Among 2,460 patients with severe AS and hypertension receiving antihypertensive therapy in the CURRENT AS registry-2, we compared the clinical outcomes between patients taking antihypertensive therapy with CCB (CCB group) and without CCB (no CCB group). In the entire study population, CCB was prescribed in 1,763 patients (71.7%), which was the most commonly prescribed antihypertensive agents. The prescription rates of angiotensin converting enzyme inhibitors or angiotensin receptor blockers, beta-blockers, and thiazides were 61.9%, 25.6%, and 7.3% in the CCB group, and 75.8%, 54.4%, and 6.0% in the no CCB group. In the propensity score matched cohort, the cumulative 3-year incidence of all-cause death or hospitalization for heart failure was not different between the CCB and no CCB groups (38.3% vs. 38.7%, log-rank P=0.65; HR, 0.94; 95%CI, 0.77-1.15; P=0.56). The cumulative 3-year incidence of syncope was low regardless of CCB prescription (1.1% vs. 1.0%, P=0.74).
Among patients with severe AS and hypertension, CCB was the most commonly prescribed antihypertensive agents, and antihypertensive therapy with CCB was associated with comparable clinical outcomes to antihypertensive therapy without CCB. Syncope was rarely seen in patients with severe AS and hypertension receiving antihypertensive therapy regardless of CCB prescription.
关于钙通道阻滞剂（CCB）在重度主动脉瓣狭窄（AS）合并高血压患者中的安全性数据较少。
在CURRENT AS注册研究-2中，2460例接受抗高血压治疗的重度AS合并高血压患者中，我们比较了服用CCB进行抗高血压治疗的患者（CCB组）和未服用CCB的患者（非CCB组）的临床结局。在整个研究人群中，1763例患者（71.7%）使用了CCB，这是最常用的抗高血压药物。CCB组中血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂、β受体阻滞剂和噻嗪类药物的处方率分别为61.9%、25.6%和7.3%，非CCB组分别为75.8%、54.4%和6.0%。在倾向评分匹配队列中，CCB组和非CCB组全因死亡或心力衰竭住院的3年累积发生率无差异（38.3%对38.7%，对数秩检验P=0.65；HR，0.94；95%CI，0.77-1.15；P=0.56）。无论是否使用CCB，晕厥的3年累积发生率均较低（1.1%对1.0%，P=0.74）。
在重度AS合并高血压患者中，CCB是最常用的抗高血压药物，使用CCB进行抗高血压治疗与未使用CCB的抗高血压治疗具有相似的临床结局。在接受抗高血压治疗的重度AS合并高血压患者中，无论是否使用CCB，晕厥均很少见。
