Psaty BM, Heckbert S, Koepsell T, Siscovick DS
The risk of myocardial infarction associated with
antihypertensive drug therapy
JAMA
(Aug) 274:620-625 1995
In this case controlled study, 623 hypertensive patients who had
sustained a fatal or non-fatal MI were matched with 2032 hypertensive
controls, and the effect of treatment with calcium channel blocking drugs
and beta blockers on the risk ratio for MI was examined. Patients
previously free of cardiovascular disease taking CCBs had a risk
ratio for MI of 1.62 (CI 1.11-2.34) relative to users of diuretics alone. In
comparing patients
taking a CCB or a beta blocker, the
risk ratio for MI was 1.57 (1.21-2.04). The risk for MI associated with
CCBs appeared to be dose dependent, whereas there was a dose-dependent
decrease in MI risk with beta-blockers. This article, which is
available in
its entirety along with an accompanying JAMA editorial by Buring et al
(which suggests that the jury is still out on this question)
(click
here), sparked a
number of press releases and news alerts, calling into question the safety
of short-acting CCB in the treatment for hypertension.
(Leehey)
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H: Drug therapy :
Calcium channel blockers
H: Special problems :
Outcomes