TY - JOUR
T1 - Sex Differences in the Anti-Hypertensive Effect of Calcium-Channel Blockers
T2 - A Systematic Review and Meta-Analysis
AU - van Luik, Eveline M.
AU - Vaes, Esmee W. P.
AU - Vesseur, Maud A. M.
AU - Wilmes, Nick
AU - Meijs, Daniek A. M.
AU - Laven, Sophie A. J. S.
AU - Mohseni-Alsalhi, Zenab
AU - de Haas, Sander
AU - Spaanderman, Marc E. A.
AU - Ghossein-Doha, Chahinda
PY - 2023/6/1
Y1 - 2023/6/1
N2 - Cardiovascular disease (CVD) is the number one cause of death worldwide, with hypertension as the leading risk factor for both sexes. As sex may affect responsiveness to antihypertensive compounds, guidelines for CVD prevention might necessitate divergence between females and males. To this end, we studied the effectiveness of calcium channel blockers (CCB) on blood pressure (BP), heart rate (HR) and cardiac function between sexes. We performed a systematic review and meta-analysis on studies on CCB from inception to May 2020. Studies had to present both baseline and follow-up measurements of the outcome variables of interest and present data in a sex-stratified manner. Mean differences were calculated using a random-effects model. In total, 38 studies with 8202 participants were used for this review. In females as compared to males, systolic BP decreased by -27.6 mmHg (95%CI -36.4; -18.8) (-17.1% (95%CI -22.5;-11.6)) versus -14.4 mmHg (95%CI -19.0; -9.9) (-9.8% (95%CI -12.9;-6.7)) (between-sex difference p < 0.01), diastolic BP decreased by -14.1 (95%CI -18.8; -9.3) (-15.2%(95%CI -20.3;-10.1)) versus -10.6 mmHg (95%CI -14.0; -7.3) (-11.2% (95%CI -14.8;-7.7)) (between-sex difference p = 0.24). HR decreased by -1.8 bpm (95%CI -2.5; -1.2) (-2.5% (95%CI -3.4; -1.6)) in females compared to no change in males (0.3 bpm (95% CI -1.2; 1.8)) (between-sex difference p = 0.01). In conclusion, CCB lowers BP in both sexes, but the observed effect is larger in females as compared to males.
AB - Cardiovascular disease (CVD) is the number one cause of death worldwide, with hypertension as the leading risk factor for both sexes. As sex may affect responsiveness to antihypertensive compounds, guidelines for CVD prevention might necessitate divergence between females and males. To this end, we studied the effectiveness of calcium channel blockers (CCB) on blood pressure (BP), heart rate (HR) and cardiac function between sexes. We performed a systematic review and meta-analysis on studies on CCB from inception to May 2020. Studies had to present both baseline and follow-up measurements of the outcome variables of interest and present data in a sex-stratified manner. Mean differences were calculated using a random-effects model. In total, 38 studies with 8202 participants were used for this review. In females as compared to males, systolic BP decreased by -27.6 mmHg (95%CI -36.4; -18.8) (-17.1% (95%CI -22.5;-11.6)) versus -14.4 mmHg (95%CI -19.0; -9.9) (-9.8% (95%CI -12.9;-6.7)) (between-sex difference p < 0.01), diastolic BP decreased by -14.1 (95%CI -18.8; -9.3) (-15.2%(95%CI -20.3;-10.1)) versus -10.6 mmHg (95%CI -14.0; -7.3) (-11.2% (95%CI -14.8;-7.7)) (between-sex difference p = 0.24). HR decreased by -1.8 bpm (95%CI -2.5; -1.2) (-2.5% (95%CI -3.4; -1.6)) in females compared to no change in males (0.3 bpm (95% CI -1.2; 1.8)) (between-sex difference p = 0.01). In conclusion, CCB lowers BP in both sexes, but the observed effect is larger in females as compared to males.
KW - hypertension
KW - cardiovascular disease
KW - calcium-channel blockers
KW - sex differences
KW - systematic review
KW - meta-analysis
KW - LEFT-VENTRICULAR PERFORMANCE
KW - CONGESTIVE-HEART-FAILURE
KW - GENDER-DIFFERENCES
KW - BLOOD-FLOW
KW - HYPERTROPHIC CARDIOMYOPATHY
KW - HYPERTENSIVE PATIENTS
KW - CLINICAL-TRIALS
KW - ORAL DILTIAZEM
KW - NIFEDIPINE
KW - PHARMACOKINETICS
U2 - 10.3390/biomedicines11061622
DO - 10.3390/biomedicines11061622
M3 - (Systematic) Review article
C2 - 37371717
SN - 2227-9059
VL - 11
JO - Biomedicines
JF - Biomedicines
IS - 6
M1 - 1622
ER -