Short-acting nifedipine and risk of stroke in elderly hypertensive patients

S. Y. Jung, N. K. Choi, J. Y. Kim, Y. Chang, H. J. Song, J. Lee, B. J. Park

Research output: Contribution to journalArticlepeer-review

27 Scopus citations


Objectives: Short-acting nifedipine is frequently prescribed in elderly hypertensive patients, despite warnings of possible harmful cardiovascular effects. We conducted a case-crossover study to estimate the risk of stroke episodes associated with use of short-acting nifedipine in elderly hypertensive patients. Methods: We used the Korea Health Insurance Review & Assessment Service database. Cases included elderly hypertensive patients with hospitalization or emergency department visits for first stroke (International Classification of Diseases-10, I60-I64) between July 1, 2005, and June 30, 2006. Patients with prior stroke-related hospital admission or any visit related to TIA were excluded. Exposure to a short-acting nifedipine formulation was assessed within 7 days before the incident stroke episode (case period) and within a 7-day period preceding 60 days before the episode (control period). Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated by conditional logistic regression, with adjusting for antihypertensives, anticoagulants, antiplatelet agents, and pneumonia. Results: A total of 16,069 stroke patients with a mean (±SD) age of 68.3 (±2.1) years were studied, of whom 8,573 (53.3%) were female. Short-acting nifedipine was prescribed at least once to 301 (1.9%) patients during the case period. An increased risk of stroke associated with use of short-acting nifedipine within 7 days (adjusted OR 2.56; 95% CI 1.96-3.37) was observed. Patients who were newly prescribed nifedipine within the recent 7 days showed an OR of 4.17 (95% CI 2.93-5.93) compared with nonusers. Conclusion: Use of short-acting nifedipine was associated with increased risk of stroke occurrence in elderly hypertensive patients.

Original languageEnglish
Pages (from-to)1229-1234
Number of pages6
Issue number13
StatePublished - 27 Sep 2011

Bibliographical note

Funding Information:
Dr. Jung reports no disclosures. Dr. Choi serves as an Associate Editor for Pharmacoepidemiology and Drug Safety . Dr. Kim, Dr. Chang, Dr. Lee, and Dr. Song report no disclosures. Dr. Park serves on the editorial boards of Pharmacoepidemiology and Drug Safety , the Journal of Korean Medical Science , the Journal of Korean Medical Association , and Cancer Research and Treatment , and Editor-in-Chief of Preventive Medicine and Public Health ; and receives research support from the Ministry of Health and Welfare and Korea Food and Drug Administration.


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