TY - JOUR
T1 - Epidemiologic review of the calcium channel blocker drugs
T2 - An up-to-date perspective on the proposed hazards
AU - Kizer, Jorge R.
AU - Kimmel, Stephen E.
PY - 2001
Y1 - 2001
N2 - In the setting of soaring popularity, postmarketing studies of calcium channel blockers came to suggest an increase in a variety of major adverse end points. The evidence, however, was largely observational, and large-scale trials capable of addressing the concerns were wanting. Clinical trials now support the safety and efficacy of the long-acting dihydropyridines for patients with both uncomplicated and diabetic hypertension, although conventional therapies and, in the latter case, angiotensin-converting enzyme inhibitors have superior proof of benefit. By contrast, short-acting dihydropyridines should be avoided. In the acute coronary syndromes, β-blockers remain the treatment of choice; the evidence for nondihydropyridines remains inconclusive. Stable angina calls for β-blockers as first-line therapy and nondihydropyridines as second-line therapy, whereas in ventricular dysfunction, safety data for nondihydropyridines are lacking. Initial reports of cancer, bleeding, and suicide have been contradicted by subsequent data, making the associations uncertain or unlikely. Remaining questions await completion of ongoing trials to better define the indications for these agents.
AB - In the setting of soaring popularity, postmarketing studies of calcium channel blockers came to suggest an increase in a variety of major adverse end points. The evidence, however, was largely observational, and large-scale trials capable of addressing the concerns were wanting. Clinical trials now support the safety and efficacy of the long-acting dihydropyridines for patients with both uncomplicated and diabetic hypertension, although conventional therapies and, in the latter case, angiotensin-converting enzyme inhibitors have superior proof of benefit. By contrast, short-acting dihydropyridines should be avoided. In the acute coronary syndromes, β-blockers remain the treatment of choice; the evidence for nondihydropyridines remains inconclusive. Stable angina calls for β-blockers as first-line therapy and nondihydropyridines as second-line therapy, whereas in ventricular dysfunction, safety data for nondihydropyridines are lacking. Initial reports of cancer, bleeding, and suicide have been contradicted by subsequent data, making the associations uncertain or unlikely. Remaining questions await completion of ongoing trials to better define the indications for these agents.
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U2 - 10.1001/archinte.161.9.1145
DO - 10.1001/archinte.161.9.1145
M3 - Review article
C2 - 11343438
AN - SCOPUS:0034927862
SN - 0003-9926
VL - 161
SP - 1145
EP - 1158
JO - Archives of internal medicine
JF - Archives of internal medicine
IS - 9
ER -