{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T06:27:31Z","timestamp":1777530451343,"version":"3.51.4"},"reference-count":65,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2018,5,8]],"date-time":"2018-05-08T00:00:00Z","timestamp":1525737600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cardiovasc Pharmacol Ther"],"published-print":{"date-parts":[[2018,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Dihydropyridine calcium channel blockers are a heterogeneous group of antihypertensive drugs. Long-acting dihydropyridine agent amlodipine is widely used for monotherapy and combination therapy for hypertension in clinical practice, while intermediate-acting dihydropyridine agents have shown inconsistent results in randomized clinical trials (RCTs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results:<\/jats:title>\n                    <jats:p>A meta-analysis of 18 RCTs enrolling a total of 80,483 patients with hypertension followed for a mean of 51.4 months was performed. Amlodipine therapy was associated with 25% higher risk of heart failure (relative risk [RR]: 1.25, 95% confidence interval [CI], 1.05-1.49, P = .019) but 17% lower risk of stroke (RR: 0.83, [95% CI, 0.72-0.97], P = .009) without statistically significant effect on acute myocardial infarction (AMI) compared to major alternative antihypertensive therapy (MAAT), including \u03b2-blocker, diuretic, angiotensin-converting enzyme inhibitor, or angiotensin-receptor blocker. Intermediate-acting dihydropyridine calcium channel blocker therapy was associated with 25% higher risk of heart failure (RR: 1.25, [95% CI, 1.06-1.47], 0.005, P = .005) and 26% higher risk of AMI (RR: 1.26, [95% CI, 1.05-1.51], 0.019, P = .019) compared to MAAT. Results of the subgroup analysis suggested that the intermediate-acting dihydropyridine calcium channel blocker was associated with higher risk of heart failure (RR: 1.30, [95% CI, 1.08-1.56], P = .005) and AMI (RR: 1.50, [95% CI, 1.01-2.22], P = .043) compared to renin\u2013angiotensin system blockers and a trend toward higher risk of AMI (RR: 1.17, [95% CI, 0.99-1.38], P = .064) compared to conventional therapy, including \u03b2-blockers and diuretics. Meta-regression analyses suggested that long-acting dihydropyridine calcium channel blocker is associated with lower risk of AMI ( B: \u22120.327, [95% CI, \u22120.530 to \u22120.123], P = .002) with a trend toward lower risk of stroke ( B: \u22120.203, [95% CI, \u22120.410 to 0.003] P = .054).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study suggests that Amlodipine offers greater protection against major complications of hypertension compared to intermediate-acting dihydropyridine calcium channel blockers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1074248418771341","type":"journal-article","created":{"date-parts":[[2018,5,8]],"date-time":"2018-05-08T22:15:27Z","timestamp":1525817727000},"page":"433-445","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":13,"title":["Effects of Long- and Intermediate-Acting Dihydropyridine Calcium Channel Blockers in Hypertension"],"prefix":"10.1177","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7647-9236","authenticated-orcid":false,"given":"Sandip","family":"Chaugai","sequence":"first","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lhamo Yangchen","family":"Sherpa","sequence":"additional","affiliation":[{"name":"Section for Preventive Medicine and Epidemiology, Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir Ali","family":"Sepehry","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott Reza Jafarian","family":"Kerman","sequence":"additional","affiliation":[{"name":"Division of Clinical Pharmacology, Department of Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hisatomi","family":"Arima","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Preventive Medicine and Public Health, Fukuoka University, Fukuoka, Japan"},{"name":"The George Institute for Global Health, University of Sydney, Sydney, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,5,8]]},"reference":[{"key":"bibr1-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2005050522"},{"key":"bibr2-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1097\/00005344-200312001-00016"},{"key":"bibr3-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000227223.90239.13"},{"key":"bibr4-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2007.01775.x"},{"key":"bibr5-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1080\/08037050510034185"},{"key":"bibr6-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1291\/hypres.31.271"},{"key":"bibr7-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9343(03)00158-X"},{"key":"bibr8-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1093\/ajh\/hpv050"},{"key":"bibr9-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1177\/1074248415619490"},{"key":"bibr10-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000004059"},{"key":"bibr11-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1038\/sj.jhh.1001931"},{"key":"bibr12-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)03306-7"},{"key":"bibr13-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e3283281254"},{"key":"bibr14-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.92.5.1068"},{"key":"bibr15-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.97.16.1540"},{"key":"bibr16-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00445-2"},{"key":"bibr17-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199911043411907"},{"key":"bibr18-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.112.096156"},{"key":"bibr19-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199803053381003"},{"key":"bibr20-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000039288.86470.DD"},{"key":"bibr21-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1080\/08037050310009545"},{"key":"bibr22-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)14739-3"},{"key":"bibr23-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06411-X"},{"key":"bibr24-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1097\/00004872-200306000-00002"},{"key":"bibr25-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"bibr26-1074248418771341","doi-asserted-by":"publisher","DOI":"10.2307\/2533446"},{"key":"bibr27-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.315.7109.629"},{"key":"bibr28-1074248418771341","volume-title":"Comprehensive Meta-Analysis. A Computer Program for Research Synthesis","author":"Borenstein M","year":"1999"},{"key":"bibr29-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(99)10327-1"},{"key":"bibr30-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1996.03540100029024"},{"key":"bibr31-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/01.HYP.34.5.1129"},{"key":"bibr32-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.0000166048.35740.a9"},{"key":"bibr33-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1291\/hypres.27.181"},{"key":"bibr34-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02527-7"},{"key":"bibr35-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.202309"},{"key":"bibr36-1074248418771341","doi-asserted-by":"publisher","DOI":"10.2337\/diacare.21.4.597"},{"key":"bibr37-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1001\/jama.288.23.2981"},{"key":"bibr38-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2006.08.004"},{"key":"bibr39-1074248418771341","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-7-200304010-00010"},{"key":"bibr40-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16451-9"},{"key":"bibr41-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euq439"},{"key":"bibr42-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.111.184226"},{"key":"bibr43-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)02327-8"},{"key":"bibr44-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.6.539"},{"key":"bibr45-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/HYPERTENSIONAHA.107.089763"},{"key":"bibr46-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/j.jash.2014.02.004"},{"key":"bibr47-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002995"},{"key":"bibr48-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.595496"},{"key":"bibr49-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1038\/hr.2013.125"},{"key":"bibr50-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-7061(98)00032-6"},{"key":"bibr51-1074248418771341","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200767090-00005"},{"key":"bibr52-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(97)00722-4"},{"key":"bibr53-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/0895-7061(96)87762-4"},{"issue":"10","key":"bibr54-1074248418771341","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1111\/j.1742-1241.1989.tb08777.x","volume":"43","author":"Purcell H","year":"1989","journal-title":"Br J Clin Pract"},{"key":"bibr55-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00095-8"},{"key":"bibr56-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.12.1410"},{"issue":"15","key":"bibr57-1074248418771341","first-page":"1967","volume-title":"JAMA","volume":"283","year":"2000"},{"key":"bibr58-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1001\/jama.290.21.2805"},{"key":"bibr59-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)05381-6"},{"key":"bibr60-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.2.211"},{"key":"bibr61-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2003.12.155"},{"key":"bibr62-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.86.5.558"},{"key":"bibr63-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1995.03530080036038"},{"key":"bibr64-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(96)00734-5"},{"key":"bibr65-1074248418771341","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01534-0"}],"container-title":["Journal of Cardiovascular Pharmacology and Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1074248418771341","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1074248418771341","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1074248418771341","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:42:47Z","timestamp":1777394567000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.sagepub.com\/doi\/10.1177\/1074248418771341"}},"subtitle":["A Systematic Review and Meta-Analysis of 18 Prospective, Randomized, Actively Controlled Trials"],"short-title":[],"issued":{"date-parts":[[2018,5,8]]},"references-count":65,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,9]]}},"alternative-id":["10.1177\/1074248418771341"],"URL":"https:\/\/doi.org\/10.1177\/1074248418771341","relation":{},"ISSN":["1074-2484","1940-4034"],"issn-type":[{"value":"1074-2484","type":"print"},{"value":"1940-4034","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,8]]}}}