Calcium channel blockers for hypertension: dissecting the evidence for adverse effects

American Journal of Hypertension
L H Opie

Abstract

Safety in the drug treatment of hypertension can only be seen in relation to efficacy, which has now come to mean not just blood pressure (BP) reduction but improvements in hard end points including mortality. Information on safety can come from a variety of sources, in an ascending hierarchy, which is as follows: case-control studies, cohort studies, randomized control trials (RCTs), and metaanalyses based on good RCTs. Only in the case of metaanalyses are definite criteria for acceptability established, but evaluation of case-control and cohort studies remains subjective. Despite these reserves about the data sources, it is proposed that the case-control study pointing to the risk of acute myocardial infarction during therapy with short-acting calcium channel blockers (CCBs) can be balanced out by another better more recent study, and by a large cohort study from Israel. In a very elderly population, a well-designed cohort study strongly suggests that short-acting nifedipine can be linked to increased mortality and that the specific links may be with a high dose and when the initial BP is less than 160/90 mm Hg. However, initial BP was only available in an unspecified number of patients. The risk of using short-acting verapam...Continue Reading

Citations

Jan 30, 2007·Cephalalgia : an International Journal of Headache·J HaanM D Ferrari
Nov 26, 2008·Pharmacoepidemiology and Drug Safety·C J MaxwellE M Ebly
May 13, 2019·Current Pain and Headache Reports·Shema Mathew, Jessica Ailani
Mar 21, 1998·Cardiology Clinics·D Perloff

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.