Safety of levamlodipine in patients with hypertension: a systematic review

Cai Xuyang; Yang Tian; Jin Zhaohui; Wu Bin; Wu Fengbo; Xu Ting

doi:10.3969/j.issn.1674-4055.2019.07.06

Abstract：Objective To review systematically the safety of levamlodipine (LA) in treatment of hypertension, and provide evidence for safe medication in clinical practice. Methods The databases of Ovid EMBase, PubMed, Cochrane Library, CNKI, CBM, VIP and WanFang Data were retrieved with computer from establishing time to Dec. 2017. The literature was screened, data was extracted and bias risks of included studies were reviewed by 2 researchers independently, and then a Meta-analysis was conducted by using Rev Man 5.3 software. Results There were totally 342 studies included involving 193 RCT, 42 non-RCT, 5 cohort studies and 102 case reports. The study results showed that: ①the clinical symptoms of LA-induced adverse reactions were mainly ankle edema, palpitation, flushing, headache and dizzy; ②the results of Meta-analysis for RCT, non-RCT and cohort studies showed that the incidence of cardiovascular and neural adverse reactions induced by LA were lower than that induced by other calcium channel blocker (CCB); the results of Meta-analysis for RCT and non-RCT showed that the incidence of digestive adverse reactions induced by LA were lower than that induced by other CCB; the results of Meta-analysis for RCT showed that the incidence of cardiovascular adverse reactions induced by LA were higher than that induced by ACEI/ARB; and the results of Meta-analysis for RCT showed that the incidence of cardiovascular and neural adverse reactions and systemic damage induced by LA was lower than that induced by diuretics. Conclusion LA can reduce adverse reactions with higher safety in hypertensive patients according to current clinical evidence. But the above results should be further verified by high-quality studies because of limited quality of included studies.