Association of calcium channel blocker use and pregnancy-associated plasma protein-A among older adults with hypertension : results from the ilSIRENTE study

BACKGROUND: Pregnancy-associated plasma protein A (PAPP-A) is a zinc-binding matrix metalloproteinase (MMP) that was shown to increase in acute coronary syndromes. Calcium channel blockers (CCB) can influence the production of several MMPs, but no study, so far, has assessed the association between use of CCB and PAPP-A levels. The aim of the present cross-sectional study was to evaluated if, among older hypertensive adults, PAPP-A levels differ according to use of CCB. METHODS: Data are from the baseline evaluation of the ilSIRENTE study, which enrolled 364 participants 80 years old or older. For the present study, we selected 314 participants with hypertension. Analyses of covariance were performed to evaluate the differences in PAPP-A levels according to use of CCB. RESULTS: Mean age of participants was 85.6 years (standard deviation [SD] 4.8), 206 (66%) were women; 58 participants (19%) were using a CCB. After adjusting for potential confounders, concentration of PAPP-A was significantly lower in CCB users than in nonusers (1.58 mIU/L, 95% confidence interval [CI], 1.37-1.81 vs 1.86 mIU/L, 95% CI, 1.74-1.98; p =.03). This association was still consistent after exclusion of participants with cardiovascular disease (1.53 mIU/L, 95% CI, 1.30-1.80 vs 1.90 mIU/L, 95% CI, 1.78-2.03; p =.01). CONCLUSIONS: Use of CCB is associated with lower levels of PAPP-A. These findings need to be confirmed in prospective studies.