Calcium channel antagonists: friend or foe in postinfarction patients?

American Journal of Hypertension
R S Gibson, W E Boden

Abstract

Calcium antagonists represent a diverse group of therapeutic agents with heterogenous pharmacologic, pharmacokinetic, and pharmacodynamic properties. It seems clear that the role of these agents in the management of patients with ischemic heart disease and hypertension is, in part, predicated on the subclass of calcium antagonists (dihydropyridine versus nondihydropyridine [heart rate-lowering]) that are used. The reports by Psaty and Furberg are important in that they remind clinicians of the fact that use of short-acting dihydropyridine agents may be associated with increased cardiac event rates in patients with ischemic heart disease and hypertension. It is our opinion, however, that there are no data that support the extrapolation of these untoward effects to the more contemporary, long-acting dihydropyridines (eg, amlodipine) or, especially, to the non-dihydropyridine (heart rate-lowering) calcium antagonists, such as diltiazem or verapamil. On the contrary, data pooled from homogeneous populations of post-MI patients from DRS, MDPIT, DAVIT-I, and DAVIT-II indicate that clinical outcomes are favorably influenced in patients recovering from non-Q wave MI, and in hypertensive post-MI patients with preserved left ventricular ...Continue Reading

Citations

Feb 24, 2001·Clinical Cardiology·W E BodenR Scheldewaert

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