What, if anything, is controversial about calcium antagonists?

American Journal of Hypertension
Franz H Messerli

Abstract

Recent publications purporting to show that calcium antagonists, when used for the treatment of hypertension or in the post myocardial infarction patient, would paradoxically increase the rate of heart attack and mortality have cast doubts on the safety and efficacy of this drug class. All three studies are retrospective, and have various drawbacks. Specifically, the metaanalysis of Furberg et al is fraught with mistakes, of borderline significance, and based on old data pertaining to short-acting nifedipine only (which should not be given in patients who have suffered an acute heart attack). The case control study of Psaty et al suggested that hypertensive patients who were treated with short-acting verapamil, diltiazem, and nifedipine had an excessive rate of myocardial infarction when compared with patients who were treated with diuretics. Two out of the three calcium antagonists that were used in this study were not approved for the treatment of hypertension by the US Food and Drug Administration. Some patients were taking these drugs only once a day whereas, because of their short duration of action, at least a three or four times daily regimen would be required to achieve an acceptable blood pressure control throughout a ...Continue Reading

Citations

Apr 21, 2004·Journal of Hypertension·Guido Grassi
Feb 24, 2001·Clinical Cardiology·W E BodenR Scheldewaert
Jan 25, 2000·American Journal of Physiology. Heart and Circulatory Physiology·C Wei, J C Burnett
Apr 5, 2003·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Shoji SuzukiIwao Yamaguchi
Nov 26, 2008·Pharmacoepidemiology and Drug Safety·C J MaxwellE M Ebly
Sep 27, 2003·Arteriosclerosis, Thrombosis, and Vascular Biology·R P MasonT H Hintze
Nov 19, 2003·American Journal of Therapeutics·Zafar H Israili
Dec 2, 2010·Cardiovascular Diabetology·Vasundhara KainSandhya L Sitasawad

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