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