{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T21:42:07Z","timestamp":1773351727693,"version":"3.50.1"},"reference-count":48,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,4,21]],"date-time":"2015-04-21T00:00:00Z","timestamp":1429574400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2015,6]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>Due to their potential anti\u2010platelet effect, it is suggested that calcium channel blockers (CCB<\/jats:styled-content>s) are associated with gastrointestinal bleeding (GIB<\/jats:styled-content>). However, results from previous studies are conflicting.<\/jats:p><\/jats:sec>Aim<\/jats:title>To conduct a systematic review and meta\u2010analysis of randomised controlled trials (RCT<\/jats:styled-content>s) and observational studies to clarify the association between CCB<\/jats:styled-content>s and GIB<\/jats:styled-content>.<\/jats:p><\/jats:sec>Methods<\/jats:title>We conducted a systematic search of PubMed, EMBASE<\/jats:styled-content>, Cochrane library and Trial Register databases up to January 2015. Studies that evaluated exposure to CCB<\/jats:styled-content>s reporting GIB<\/jats:styled-content> outcomes were included in the meta\u2010analysis. The inverse variance method with random effects model was used to calculate the pooled estimates.<\/jats:p><\/jats:sec>Results<\/jats:title>Seventeen studies (four RCT<\/jats:styled-content>s, eleven case\u2013control and two cohort studies) were included in the meta\u2010analysis. The summary risk ratio (RR<\/jats:styled-content>) for GIB<\/jats:styled-content> was 1.17 (95% CI<\/jats:styled-content> 1.01\u20131.36) for CCB<\/jats:styled-content> users vs. non\u2010users. Subgroup analysis showed that CCB<\/jats:styled-content> use was associated with a moderately higher risk of lower GIB<\/jats:styled-content> (RR<\/jats:styled-content>\u00a0=\u00a01.83, 95% CI<\/jats:styled-content> 1.17\u20132.84) but not upper GIB<\/jats:styled-content>. However, data from four RCT<\/jats:styled-content>s did not support association between CCB<\/jats:styled-content>s and GIB<\/jats:styled-content> (RR<\/jats:styled-content>\u00a0=\u00a00.93, 95% CI<\/jats:styled-content> 0.82\u20131.05). Subgroup analyses further showed that the increased risk of GIB<\/jats:styled-content> among CCB<\/jats:styled-content> users was only observed in studies that failed to adjust for prior history of GIB<\/jats:styled-content> (RR<\/jats:styled-content>\u00a0=\u00a01.67, 95% CI<\/jats:styled-content> 1.34\u20132.08) or use of anti\u2010ulcer drugs (RR<\/jats:styled-content>\u00a0=\u00a01.40, 95% CI<\/jats:styled-content> 1.19\u20131.65).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Our meta\u2010analysis showed a marginal association between calcium channel blocker use and the risk of gastrointestinal bleeding. This association is of dubious clinical significance, as the effects of different comparators or adjustment for confounding factors render this association nonsignificant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13211","type":"journal-article","created":{"date-parts":[[2015,4,21]],"date-time":"2015-04-21T12:38:51Z","timestamp":1429619931000},"page":"1246-1255","source":"Crossref","is-referenced-by-count":18,"title":["Systematic review with meta\u2010analysis: the association between the use of calcium channel blockers and gastrointestinal bleeding"],"prefix":"10.1111","volume":"41","author":[{"given":"Y.","family":"He","sequence":"first","affiliation":[{"name":"Department of Pharmacology and Pharmacy Centre for Safe Medication Practice and Research The University of Hong Kong Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. 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