Cardiovascular outcomes of β-blocker-calcium channel blocker initial dual therapy vs. other initial dual therapies in Chinese patients with hypertension: A real-world retrospective study

J Clin Hypertens (Greenwich). 2023 May;25(5):440-452. doi: 10.1111/jch.14665. Epub 2023 Apr 29.

Abstract

This retrospective study compared cardiovascular (CV) outcomes between initial β-blocker (BB) + calcium channel blocker (CCB) dual therapy ("B + C") and other initial dual therapies in Chinese newly diagnosed hypertensive patients. In this study, all patients in a regional electronic database with newly diagnosed hypertension from January 01, 2012 to December 31, 2016 who received any initial optimal dual therapy recommended by the Chinese hypertension guideline were included. 1:2 propensity score matching (PSM) was used to balance baseline characteristics between patients receiving B + C and patients receiving other initial dual therapies ("Others"). The primary outcome was major adverse cardiovascular events (MACE) that occurred from January 01, 2012 to December 31, 2017, consisting of non-fatal stroke, non-fatal myocardial infarction (MI), non-fatal chronic heart failure (CHF), and all-cause death. Cox proportional hazard models were used to compare these CV outcomes in the 2 matched cohorts. After the PSM, 6227 patients receiving B + C and 12 454 patients receiving Others were included. Compared to patients receiving Others, patients receiving B + C had a significantly lower risk of MACE (hazard ratio [HR] 0.85; 95% confidential interval [CI] 0.78-0.92; p < .001), non-fatal stroke (HR 0.89; 95% CI 0.81-0.98; p = .018) and non-fatal CHF (HR 0.74; 95% CI 0.63-0.86; p < .0001). Additionally, differences in risks of non-fatal MI and all-cause death between the 2 treatment cohorts were not statistically significant. In conclusion, BB + CCB initial dual therapy was associated with a lower risk of MACE, stroke, and CHF than other optimal initial dual therapies recommended by the Chinese hypertension guideline in Chinese newly diagnosed hypertensive patients.

Keywords: calcium channel blocker; hypertension; initial dual therapy; major adverse cardiovascular events; β-blocker.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenergic beta-Antagonists* / administration & dosage
  • Adrenergic beta-Antagonists* / therapeutic use
  • Calcium Channel Blockers* / administration & dosage
  • Calcium Channel Blockers* / therapeutic use
  • East Asian People
  • Heart Failure / epidemiology
  • Heart Failure / prevention & control
  • Humans
  • Hypertension* / drug therapy
  • Hypertension* / epidemiology
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / prevention & control
  • Retrospective Studies
  • Stroke / epidemiology
  • Stroke / prevention & control

Substances

  • Adrenergic beta-Antagonists
  • Calcium Channel Blockers