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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

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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.

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Acknowledgments

We would like to thank the Japan Pharmaceutical Association and the Kumamoto Pharmaceutical Association, for providing the clinical data from a cross-sectional nation-wide survey of the JPA DEM project. This work was supported by a grant-in-aid for scientific research: KAKENHI(C) No. 23510348, from the Ministry of Education, Culture, Sports, Science and Technology, Japan, and by a grant from the Smoking Research Foundation. None of the authors declared any conflict of interest.

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Authors and Affiliations

  1. Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Center for Clinical Pharmaceutical Sciences, Kumamoto University, 5-1 Oe-honmachi, Chuo-ku, Kumamoto, 862-0973, Japan

    Ayami Kajiwara, Junji Saruwatari, Ayana Kita, Kentaro Oniki & Kazuko Nakagawa

  2. Kumamoto Pharmaceutical Association, Kumamoto, Japan

    Masato Yamamura, Motoji Murase, Haruo Koda, Seisuke Hirota & Tadao Ishizuka

  3. Division of Pharmaceutical Molecular Design, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan

    Tadao Ishizuka

  4. Center for Clinical Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan

    Kazuko Nakagawa

Authors
  1. Ayami Kajiwara
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  2. Junji Saruwatari
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  3. Ayana Kita
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  4. Kentaro Oniki
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  5. Masato Yamamura
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  7. Haruo Koda
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  8. Seisuke Hirota
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  9. Tadao Ishizuka
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  10. Kazuko Nakagawa
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Corresponding author

Correspondence to Kazuko Nakagawa.

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Kajiwara, A., Saruwatari, J., Kita, A. et al. 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. Clin Drug Investig 34, 431–435 (2014). https://doi.org/10.1007/s40261-014-0191-4

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  • DOI: https://doi.org/10.1007/s40261-014-0191-4

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