Comparative Cardiovascular Outcomes of Fimasartan and Calcium Channel Blockers in Hypertension: A Nationwide 3-Year Follow-Up Cohort Study
9 affiliations
- 1Division of Cardiology, Department of Internal Medicine, Uijeonbu St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea
- 2Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul 03063, Republic of Korea
- 3Dr. Jeong’s Heart Clinic, Jeonju 54985, Republic of Korea
- 4Department of Cardiology, Ajou University School of Medicine, Suwon 16499, Republic of Korea
- 5Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
- 6Division of Cardiology, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea
- 7Department of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul 02841, Republic of Korea
- 8Division of Cardiology, Department of Internal Medicine, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea
- 9Division of Cardiology, Department of Internal Medicine, College of Medicine, Chung-Ang University Hospital, Seoul 06973, Republic of Korea
Abstract
Background: Fimasartan is an angiotensin II receptor blocker (ARB) that was developed in Korea. Although ARBs and calcium channel blockers (CCBs) are both recommended first-line antihypertensive drug classes, real-world outcome data comparing fimasartan specifically with CCBs remain limited. Methods: We analyzed Korean National Health Insurance Service data for adults aged ≥20 years with hypertension and no prior cardiovascular disease. The primary inferential analysis was treatment-naïve new users of fimasartan or CCB monotherapy using a 30-day landmark design, with outcome follow-up beginning on day 31. The primary endpoint was 3-year major adverse cardiovascular events (MACEs), defined as all-cause death, cardiac death, nonfatal myocardial infarction, or nonfatal stroke. Multivariable Cox models were used for the primary analysis, while broader overall-cohort and propensity-score-matched analyses were considered secondary. Results: In the primary treatment-naïve new-user analysis, fimasartan was associated with a numerically lower MACE risk than CCBs, although the 95% confidence interval included the null value (adjusted HR 0.895, 95% CI 0.796–1.006; p = 0.0628). In secondary analyses of the broader overall cohort, fimasartan was associated with a lower adjusted MACE risk (HR 0.851, 95% CI 0.815–0.890), and the association remained evident after propensity-score matching (HR 0.675, 95% CI 0.653–0.699). Exploratory comparisons showed nearly identical crude MACE rates for fimasartan+CCB and fimasartan+thiazide regimens (3.46% vs. 3.47%). Conclusions: In this nationwide observational cohort, the primary treatment-naïve new-user analysis showed a numerically lower 3-year MACE risk with fimasartan than with CCBs, although the confidence interval included the null value. Stronger associations observed in secondary analyses of the broader cohort should be interpreted cautiously because residual confounding and selection bias cannot be excluded.
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BibTeX
@article{ahn2026comparative,
title = {{Comparative Cardiovascular Outcomes of Fimasartan and Calcium Channel Blockers in Hypertension: A Nationwide 3-Year Follow-Up Cohort Study}},
author = {Yuran Ahn and Ji In Lee and Han Saem Jeong and Hong-Seok Lim and Jin-Oh Choi and Sang-Ho Jo and Soon Jun Hong and Hyo-Suk Ahn and Hae Ok Jung and Wang Soo Lee and Hun-Jun Park},
journal = {Journal of clinical medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15197669},
url = {https://europepmc.org/article/PMC/PMC13666065},
note = {CC BY},
}
RIS
TY - JOUR
TI - Comparative Cardiovascular Outcomes of Fimasartan and Calcium Channel Blockers in Hypertension: A Nationwide 3-Year Follow-Up Cohort Study
AU - Yuran Ahn
AU - Ji In Lee
AU - Han Saem Jeong
AU - Hong-Seok Lim
AU - Jin-Oh Choi
AU - Sang-Ho Jo
AU - Soon Jun Hong
AU - Hyo-Suk Ahn
AU - Hae Ok Jung
AU - Wang Soo Lee
AU - Hun-Jun Park
PY - 2026
DA - 2026/10/01
JO - Journal of clinical medicine
DO - 10.3390/jcm15197669
UR - https://europepmc.org/article/PMC/PMC13666065
AB - Background: Fimasartan is an angiotensin II receptor blocker (ARB) that was developed in Korea. Although ARBs and calcium channel blockers (CCBs) are both recommended first-line antihypertensive drug classes, real-world outcome data comparing fimasartan specifically with CCBs remain limited. Methods: We analyzed Korean National Health Insurance Service data for adults aged ≥20 years with hypertension and no prior cardiovascular disease. The primary inferential analysis was treatment-naïve new users of fimasartan or CCB monotherapy using a 30-day landmark design, with outcome follow-up beginning on day 31. The primary endpoint was 3-year major adverse cardiovascular events (MACEs), defined as all-cause death, cardiac death, nonfatal myocardial infarction, or nonfatal stroke. Multivariable Cox models were used for the primary analysis, while broader overall-cohort and propensity-score-matched analyses were considered secondary. Results: In the primary treatment-naïve new-user analysis, fimasartan was associated with a numerically lower MACE risk than CCBs, although the 95% confidence interval included the null value (adjusted HR 0.895, 95% CI 0.796–1.006; p = 0.0628). In secondary analyses of the broader overall cohort, fimasartan was associated with a lower adjusted MACE risk (HR 0.851, 95% CI 0.815–0.890), and the association remained evident after propensity-score matching (HR 0.675, 95% CI 0.653–0.699). Exploratory comparisons showed nearly identical crude MACE rates for fimasartan+CCB and fimasartan+thiazide regimens (3.46% vs. 3.47%). Conclusions: In this nationwide observational cohort, the primary treatment-naïve new-user analysis showed a numerically lower 3-year MACE risk with fimasartan than with CCBs, although the confidence interval included the null value. Stronger associations observed in secondary analyses of the broader cohort should be interpreted cautiously because residual confounding and selection bias cannot be excluded.
SN - 2077-0383
ER -