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Adverse effects of hypertensive agents

Evidence Summaries

Level of Evidence = A

Calcium channel blockers are as safe as beta blockers with respect to serious adverse effects. Headache and oedema are more common with calcium channel blockers than with diuretics, and flushing are more common with calcium channel blockers than with beta blockers.

A systematic review 1 including 28 RCTs with a total of 3073 subjects assessing calcium channel blockers (CCB) versus beta blockers or diuretics was abstracted in DARE. There was no difference in the total incidence of serious adverse effects. Headache and oedema occurred significantly more frequently in CCB. The risk difference between CCBs and diuretics was 7.36% (95% CI 1.90 to 12.81%) for headache and 6.57% (95% CI 1.29% to 11.84%) for oedema. Flushing occurred 8.75% more frequently with CCBs compared with beta blockers (95% CI 4.00% to 13.94%). Tachycardia and oedema occurred in the CCB group slightly more frequently than beta blockers (difference not statistically significant).

Comment: A well performed systematic review.

References

1. Sakai H, Hayashi K, Origasa H, Kusunoki T. An application of meta-analysis techniques in the evaluation of adverse experiences with antihypertensive agents. Pharmacoepidemiol Drug Saf 1999 May;8(3):169-77.  [PMID:15073926]


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Citation

"Adverse Effects of Hypertensive Agents." Evidence-Based Medicine Guidelines, Duodecim Medical Publications Limited, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/EBMG/453760/all/Adverse_effects_of_hypertensive_agents.
Adverse effects of hypertensive agents. Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. https://evidence.unboundmedicine.com/evidence/view/EBMG/453760/all/Adverse_effects_of_hypertensive_agents. Accessed April 24, 2019.
Adverse effects of hypertensive agents. (2019). In Evidence-Based Medicine Guidelines. Available from https://evidence.unboundmedicine.com/evidence/view/EBMG/453760/all/Adverse_effects_of_hypertensive_agents
Adverse Effects of Hypertensive Agents [Internet]. In: Evidence-Based Medicine Guidelines. Duodecim Medical Publications Limited; 2019. [cited 2019 April 24]. Available from: https://evidence.unboundmedicine.com/evidence/view/EBMG/453760/all/Adverse_effects_of_hypertensive_agents.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Adverse effects of hypertensive agents ID - 453760 BT - Evidence-Based Medicine Guidelines UR - https://evidence.unboundmedicine.com/evidence/view/EBMG/453760/all/Adverse_effects_of_hypertensive_agents PB - Duodecim Medical Publications Limited DB - Evidence Central DP - Unbound Medicine ER -