Top

Published in:

01-06-2014 | Short Communication

Younger Females Are at Greater Risk of Vasodilation-Related Adverse Symptoms Caused by Dihydropyridine Calcium Channel Blockers: Results of a Study of 11,918 Japanese Patients

Authors: Ayami Kajiwara, Junji Saruwatari, Ayana Kita, Kentaro Oniki, Masato Yamamura, Motoji Murase, Haruo Koda, Seisuke Hirota, Tadao Ishizuka, Kazuko Nakagawa

Published in: Clinical Drug Investigation | Issue 6/2014

Abstract

Background and Objective

Adequate control of blood pressure in younger females is of crucial importance, because they are at higher risk of hypertensive target organ damage compared with males of similar age. In addition, female sex is a risk factor for adverse effects of antihypertensive drugs, especially dihydropyridines. This study set out to assess the incidence of adverse reactions during dihydropyridine use in a real-life clinical setting, focusing on the influence of female sex and age.

Methods

The incidence of adverse reactions to dihydropyridine calcium channel blockers were investigated in 11,918 Japanese patients who participated in the Drug Event Monitoring project of the Japan Pharmaceutical Association conducted in Kumamoto prefecture. A multiple logistic regression analysis was used to determine the association between the incidence of adverse symptoms and female sex, with adjusted odds ratios (ORs) and 95 % confidence intervals (95 % CIs).

Results

Vasodilation-related adverse symptoms occurred significantly more often in females than in males (OR 1.87, 95 % CI 1.28–2.71, p = 0.001). Furthermore, among females only, the younger age group (<50 years) complained of vasodilation-related symptoms more frequently (OR 2.39, 95 % CI 1.02–5.59, p = 0.045) and the older age group (≥80 years) complained of vasodilation-related symptoms less frequently (OR 0.56, 95 % CI 0.33–0.95, p = 0.030) than the middle age group (50–79 years).

Conclusion

To the best of our knowledge, this is the first report showing that younger females are at high risk for vasodilation-related adverse symptoms during dihydropyridine use in a real-life clinical setting. These results should be verified in clinical studies using larger samples of young patients and more parameters.

Available only for authorised users

Hadaegh F, Mohebi R, Khalili D, et al. High normal blood pressure is an independent risk factor for cardiovascular disease among middle-aged but not in elderly populations: 9-year results of a population-based study. J Hum Hypertens. 2013;27(1):18–23.PubMedCrossRef

Palatini P, Mos L, Santonastaso M, et al. Premenopausal women have increased risk of hypertensive target organ damage compared with men of similar age. J Womens Health (Larchmt). 2011;20(8):1175–81.CrossRef

Kim YS, Park HS, Sunwoo S, et al. Short-term safety and tolerability of antihypertensive agents in Korean patients: an observational study. Pharmacoepidemiol Drug Saf. 2000;9(7):603–9.PubMedCrossRef

Kubota K, Pearce GL, Inman WH. Vasodilation-related adverse events in diltiazem and dihydropyridine calcium antagonists studied by prescription-event monitoring. Eur J Clin Pharmacol. 1995;48(1):1–7.PubMedCrossRef

Kajiwara A, Saruwatari J, Sakata M, et al. Risk factors for adverse symptoms during dipeptidyl peptidase-IV inhibitor therapy: a questionnaire-based study carried out by the Japan Pharmaceutical Association Drug Event Monitoring project in Kumamoto Prefecture. Drug Saf. 2013;36(10):981–7.PubMedCrossRef

da Silva PM. Efficacy of fixed-dose combination therapy in the treatment of patients with hypertension: focus on amlodipine/valsartan. Clin Drug Investig. 2010;30(9):625–41.PubMedCrossRef

Degli Esposti E, Sturani A, Di Martino M, et al. Long-term persistence with antihypertensive drugs in new patients. J Hum Hypertens. 2002;16(6):439–44.PubMedCrossRef

Schmieder RE, Bohm M. Efficacy and safety of olmesartan medoxomil plus amlodipine in age, gender and hypertension severity defined subgroups of hypertensive patients. J Hum Hypertens. 2011;25(6):354–63.PubMedCrossRef

Wong MC, Jiang JY, Griffiths SM. Factors associated with compliance, discontinuation and switching of calcium channel blockers in 20,156 Chinese patients. Am J Hypertens. 2009;22(8):904–10.PubMedCrossRef

10.

Thoenes M, Neuberger HR, Volpe M, et al. Antihypertensive drug therapy and blood pressure control in men and women: an international perspective. J Hum Hypertens. 2010;24(5):336–44.PubMedCrossRef

11.

Trevisol DJ, Moreira LB, Fuchs FD, et al. Health-related quality of life is worse in individuals with hypertension under drug treatment: results of population-based study. J Hum Hypertens. 2012;26(6):374–80.PubMedCrossRef

12.

Fogari R, Malamani G, Corradi L, et al. Effect of valsartan or olmesartan addition to amlodipine on ankle edema in hypertensive patients. Adv Ther. 2010;27(1):48–55.PubMedCrossRef

13.

Fogari R, Zoppi A, Maffioli P, et al. Effect of telmisartan addition to amlodipine on ankle edema development in treating hypertensive patients. Expert Opin Pharmacother. 2011;12(16):2441–8.PubMedCrossRef

14.

Fogari R, Zoppi A, Mugellini A, et al. Effect of aliskiren addition to amlodipine on ankle edema in hypertensive patients: a three-way crossover study. Expert Opin Pharmacother. 2011;12(9):1351–8.PubMedCrossRef

15.

Volpe M, Brommer P, Haag U, et al. Efficacy and tolerability of olmesartan medoxomil combined with amlodipine in patients with moderate to severe hypertension after amlodipine monotherapy: a randomized, double-blind, parallel-group, multicentre study. Clin Drug Investig. 2009;29(1):11–25.PubMedCrossRef

16.

Fisslthaler B, Hinsch N, Chataigneau T, et al. Nifedipine increases cytochrome P4502C expression and endothelium-derived hyperpolarizing factor-mediated responses in coronary arteries. Hypertension. 2000;36(2):270–5.PubMedCrossRef

17.

Villar IC, Hobbs AJ, Ahluwalia A. Sex differences in vascular function: implication of endothelium-derived hyperpolarizing factor. J Endocrinol. 2008;197(3):447–62.PubMedCrossRef

Title: Younger Females Are at Greater Risk of Vasodilation-Related Adverse Symptoms Caused by Dihydropyridine Calcium Channel Blockers: Results of a Study of 11,918 Japanese Patients
Authors: Ayami Kajiwara
Junji Saruwatari
Ayana Kita
Kentaro Oniki
Masato Yamamura
Motoji Murase
Haruo Koda
Seisuke Hirota
Tadao Ishizuka
Kazuko Nakagawa
Publication date: 01-06-2014
Publisher: Springer International Publishing
Published in: Clinical Drug Investigation / Issue 6/2014
Print ISSN: 1173-2563
Electronic ISSN: 1179-1918
DOI: https://doi.org/10.1007/s40261-014-0191-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Younger Females Are at Greater Risk of Vasodilation-Related Adverse Symptoms Caused by Dihydropyridine Calcium Channel Blockers: Results of a Study of 11,918 Japanese Patients

Abstract

Background and Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and Objective

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 6/2014

Clinical Impact of Patient Adherence to a Fixed-Dose Combination of Olmesartan, Amlodipine and Hydrochlorothiazide

Availability of Data on Adverse Reactions to Antiretroviral Drugs in Medical Charts According to the Naranjo Algorithm: An Example of a Brazilian Historical Cohort

Pharmacodynamics, Pharmacokinetics, and Tolerability of Intravenous or Subcutaneous GC1113, a Novel Erythropoiesis-Stimulating Agent

Is Tocilizumab Safe in Kaposi Sarcoma? A Complex Association Among Rheumatoid Arthritis, Psoriasis, and Kaposi Sarcoma

The Effect of Therapeutic and Supratherapeutic Oral Doses of Nomegestrol Acetate (NOMAC)/17β-Estradiol (E2) on QTcF Intervals in Healthy Women: Results from a Randomized, Double-Blind, Placebo- and Positive-Controlled Trial

Pharmacokinetic and Pharmacodynamic Interaction Between Gemigliptin and Metformin in Healthy Subjects