A drug commonly used to treat high blood pressure level and chest pain may increase the risk of sudden cardiac arrest, a study has found. Sudden cardiac arrest is deadly in minutes if untreated. The study examined if nifedipine and amlodipine, dihydropyridines widely used for high blood pressure and angina, are linked with out-of-hospital cardiac arrest. The nifedipine doses most often used and studied during this investigation are 30 milligrams (mg) and 60 mg and also the amlodipine doses are 5 mg and 10 mg. Standard practice is to start with a lower dose, then provides a higher dose if blood pressure level or chest pain aren't sufficiently reduced.
“The findings have to be compelled to be replicated in alternative studies before action ought to be taken by doctors or patients,” aforementioned Hanno Tan, a cardiologist at the t Academic Medical Centre in the Netherlands.
Patients with out-of-hospital cardiac arrest due to ventricular fibrillation/tachycardia were listed, and up to 5 controls per patient matched for age and sex. Current use of high-dose (60 mg/day), however not low-dose (less than 60 mg/day), nifedipine was considerably related to an exaggerated risk of out-of-hospital cardiac arrest compared to non-use of dihydropyridines, with an odds quantitative relation of 1.5 in ARREST and 2 of.0 in DANCAR.
High-dose nifedipine was additionally related to an exaggerated risk of out-of-hospital cardiac arrest when put next with any dose of amlodipine, with odds ratios of 2.3 and 2.2 within the ARREST and DANCAR registries, severally. There was no risk related to amlodipine.
“Nifedipine and amlodipine are usually used by several cardiologists and alternative physicians, and also the choice usually depends on the prescriber’s preference and private expertise,” said Tan. “Both drugs are generally considered to be equally effective and safe and neither has been associated with sudden cardiac arrest,” he said.
“This study suggests that high-dose nifedipine could increase the risk of sudden cardiac arrest due to fatal cardiac arrhythmia whereas amlodipine doesn't. If these findings are confirmed in alternative studies, they will need to be taken into consideration once the utilization of either drug is taken into account,” he added.
These findings may be surprising given that both drugs are in use for a many years and in several patients, researchers aforementioned. A doable clarification of why this discovery has solely been made now's that out-of-hospital cardiac arrest is extremely tough to study due to its rapid course and requires dedicated data sets collected specifically for this purpose.