{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T01:58:16Z","timestamp":1785463096665,"version":"3.56.0"},"reference-count":37,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,4,26]],"date-time":"2026-04-26T00:00:00Z","timestamp":1777161600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP22H03554"],"award-info":[{"award-number":["JP22H03554"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP23K11931"],"award-info":[{"award-number":["JP23K11931"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP24K21306"],"award-info":[{"award-number":["JP24K21306"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002241","name":"Japan Science and Technology Agency","doi-asserted-by":"publisher","award":["JPMJFR205J"],"award-info":[{"award-number":["JPMJFR205J"]}],"id":[{"id":"10.13039\/501100002241","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Evidence guiding first\u2010line antihypertensive drug choice in adults aged 75\u2009years or older is limited, despite widespread use of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) in late older age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a target trial emulation using a new\u2010user design in a nationwide linked healthcare claims database in Japan. Adults aged \u2265\u200975\u2009years who had no prescription of either drug class in the preceding 12\u2009months and initiated an ARB (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910,037) or a CCB (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200919,785) were followed from treatment initiation. The primary outcome was all\u2010cause mortality; secondary outcomes included hospitalization for heart failure, myocardial infarction, stroke, and major adverse cardiovascular events (MACE). Intention\u2010to\u2010treat effects were estimated using inverse probability of treatment and censoring weighting with pooled logistic regression models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 29,822 patients, median follow\u2010up was 4.0\u2009years. During follow\u2010up, 3487 deaths occurred. ARB therapy was associated with lower all\u2010cause mortality than CCB therapy (hazard ratio [HR], 0.885; 95% CI, 0.823\u20130.951). The estimated 5\u2010year risk of death was 12.7% for ARB users and 14.8% for CCB users (absolute risk difference, \u22122.1 percentage points; 95% CI, \u22123.1 to \u22121.0). ARB therapy was also associated with lower risks of heart failure hospitalization (HR, 0.843; 95% CI, 0.774\u20130.918), myocardial infarction (HR, 0.867; 95% CI, 0.795\u20130.945), stroke (HR, 0.931; 95% CI, 0.869\u20130.998), and MACE (HR, 0.889; 95% CI, 0.848\u20130.931). Associations were consistent across age subgroups, including adults aged \u2265\u200985\u2009years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In adults aged 75\u2009years or older, ARB\u2010based antihypertensive therapy was associated with lower risks of mortality and cardiovascular events compared with CCB\u2010based therapy. These findings suggest that first\u2010line antihypertensive drug choice may have prognostic implications in late older age.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.70463","type":"journal-article","created":{"date-parts":[[2026,4,27]],"date-time":"2026-04-27T03:00:24Z","timestamp":1777258824000},"page":"1938-1949","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Angiotensin Receptor Blockers Versus Calcium Channel Blockers for First\u2010Line Antihypertensive Therapy and Survival in Adults Aged 75\u2009Years or Older"],"prefix":"10.1111","volume":"74","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2520-9949","authenticated-orcid":false,"given":"Hisashi","family":"Noma","sequence":"first","affiliation":[{"name":"Department of Interdisciplinary Statistical Mathematics The Institute of Statistical Mathematics  Tokyo Japan"},{"name":"The Graduate Institute for Advanced Studies, the Graduate University for Advanced Studies (SOKENDAI)  Tokyo Japan"},{"name":"Advanced Medicine, Innovation and Clinical Research Center Tottori University Hospital  Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroshi","family":"Sunada","sequence":"additional","affiliation":[{"name":"Advanced Medicine, Innovation and Clinical Research Center Tottori University Hospital  Tottori Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6418-0755","authenticated-orcid":false,"given":"Taiki","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Prevention and Care Science Research Institute, National Center for Geriatrics and Gerontology  Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1020-0818","authenticated-orcid":false,"given":"Ken\u2010Ei","family":"Sada","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology Kochi Medical School  Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Futoshi","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Health Care Administration and Management Kyushu University Graduate School of Medical Sciences  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megumi","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Health Care Administration and Management Kyushu University Graduate School of Medical Sciences  Fukuoka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruhisa","family":"Fukuda","sequence":"additional","affiliation":[{"name":"Department of Health Care Administration and Management Kyushu University Graduate School of Medical Sciences  Fukuoka 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