Effects of an Antihypertensive Combination in Japanese Hypertensive Outpatients Based on the Long-acting Calcium Channel Blocker Benidipine on Vascular and Renal Events: A Sub-analysis of the COPE Trial

Abstract

BACKGROUND:

In the trial known as COPE (Combination Therapy of Hypertension to Prevent Cardiovascular Events), three benidipine (a Calcium Channel Blocker; CCB) regimens were compared. Hypertensive Japanese outpatients aged 40-85 years (n=3,293) who did not achieve the target blood pressure of <140/90 mmHg with benidipine 4 mg/day were treated with the diuretic thiazide (n=1,094) or a β-blocker (n=1,089) or an additional Angiotensin Receptor Blocker (ARB; n=1,110). A significantly higher incidence of hard cardiovascular composite endpoints and of fatal or non-fatal strokes was observed in the benidipine-β-blocker group compared to the benidipine-thiazide group.

OBJECTIVE AND METHODS:

We further evaluated the treatment effects of the three benidipine-based regimens on vascular and renal events in a sub-analysis of the COPE patients.

RESULTS:

A total of 10 vascular events (0.8 per 1,000 person-years) including one aortic dissection (0.1 per 1,000 person-years) and nine cases of peripheral artery disease (0.8 per 1,000 person-years) were documented, as was a total of seven renal events (0.6 per 1,000 person-years). No significant differences in vascular and renal events were revealed among the three treatment groups: vascular events, p=0.92; renal events, p=0.16, log-rank test.

CONCLUSION:

Blood pressure-lowering therapy with benidipine combined with an ARB, β-blocker, or thiazide was similarly effective in the prevention of vascular and renal events in hypertensive outpatients, although there are not enough events to compare the difference in the three treatment groups.

• Authors: Seiji Umemoto, Toshio Ogihara, Masunori Matsuzaki, Hiromi Rakugi, Kazuyuki Shimada, Koichi Hayashi, Hirofumi Makino, Yasuo Ohashi, Takao Saruta
• Journal: Current hypertension reviews (Curr Hypertens Rev) Vol. 16 Issue 3 Pg. 238-245 ( 2020) ISSN: 1875-6506 [Electronic] United Arab Emirates
• PMID: 31995012 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright© Bentham Science Publishers; For any queries, please email at [email protected].

Chemical References

• Angiotensin Receptor Antagonists
• Angiotensin-Converting Enzyme Inhibitors
• Antihypertensive Agents
• Calcium Channel Blockers
• Dihydropyridines
• benidipine

Topics

• Angiotensin Receptor Antagonists (therapeutic use)
• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Antihypertensive Agents (adverse effects)
• Blood Pressure
• Calcium Channel Blockers (adverse effects)
• Dihydropyridines (adverse effects)
• Drug Therapy, Combination
• Humans
• Hypertension (diagnosis, drug therapy, epidemiology)
• Japan (epidemiology)
• Outpatients