TY - JOUR
T1 - Short-acting nifedipine and risk of stroke in elderly hypertensive patients
AU - Jung, S. Y.
AU - Choi, N. K.
AU - Kim, J. Y.
AU - Chang, Y.
AU - Song, H. J.
AU - Lee, J.
AU - Park, B. J.
N1 - 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.
PY - 2011/9/27
Y1 - 2011/9/27
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=82255182420&partnerID=8YFLogxK
U2 - 10.1212/WNL.0b013e318230201a
DO - 10.1212/WNL.0b013e318230201a
M3 - Article
C2 - 21849654
AN - SCOPUS:82255182420
SN - 0028-3878
VL - 77
SP - 1229
EP - 1234
JO - Neurology
JF - Neurology
IS - 13
ER -