Calcium channel blockers prescribed for hypertension were associated with an increased risk of myocardial infarction compared to diuretics alone (RR 1.6; 95% CI 1.1-2.3).
Do calcium channel blockers increase the risk of myocardial infarction in hypertensive patients compared to diuretics alone?
This editorial highlights a case-control study suggesting an increased risk of myocardial infarction among hypertensive patients treated with calcium channel blockers compared to diuretics.
Effect estimate: RR 1.6 (95% CI 1.1 to 2.3)
In this week'sJAMA, Psaty and colleagues1present findings from a case-control study that raise the possibility, but cannot evaluate definitively, whether calcium channel blockers prescribed for patients with hypertension increase risk of myocardial infarction. This retrospective study among enrollees of the Group Health Cooperative of Puget Sound compared those who had suffered a myocardial infarction (cases) with those who had not (controls), with respect to their prior use of various antihypertensive drug therapies. The authors reported that risk of myocardial infarction increased about 60% (risk ratio=1.6; 95% confidence interval CI, 1.1 to 2.3) among hypertensive patients treated with a calcium channel blocker compared with those treated with diuretics alone, and this apparent adverse effect was even greater among those treated with high doses. See also p 620. Unfortunately, media reporting of the presentation of these findings at a recent scientific meeting triggered concern among users of these and
Julie E. Buring (Wed,) conducted a editorial in Hypertension. Calcium channel blockers vs. Diuretics alone was evaluated on Myocardial infarction (RR 1.6, 95% CI 1.1 to 2.3). Calcium channel blockers prescribed for hypertension were associated with an increased risk of myocardial infarction compared to diuretics alone (RR 1.6; 95% CI 1.1-2.3).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: