Key result
Physicians selectively use CCBs for high-risk hypertension, reaching ~64% in patients with angina.
Why the study?
Are calcium channel blockers selectively used by physicians for high-risk hypertensive patients?
Cross-Sectional (n=1,023)
Are calcium channel blockers selectively used by physicians for high-risk hypertensive patients?
Survey results indicate that physicians selectively prescribe calcium channel blockers to higher-risk hypertensive patients, which may confound observational studies linking CCBs to increased cardiovascular risk.
May confound observational CCB-CV risk studies; leaves open adjusted causal inference in high-risk hypertension.
PURPOSE: While hypertension treatment is aimed at reducing cardiovascular disease (CVD) risk, there are reports of association between calcium channel blockers (CCB) use and increased risk. However, these studies may be misleading if CCBs are used selectively in high-risk patients. METHODS: We conducted a knowledge, attitudes, and practice (KAP) survey by mail of a stratified random sample of 10,000 US cardiologists, internists, and family/general practitioners. Completed surveys were received from 1023 physicians, and population means and frequencies (+/-standard errors) were estimated RESULTS: While only 36.3 (+/-0.6)% of physicians use long-acting CCBs for mild hypertension without additional risk factors, use increases with moderate or severe hypertension and other risk factors, including history of myocardial infarction (48.4 (+/-0.6)%), family history of CVD (54.6 (+/-0.6)%), diabetes (57.3 (+/-0.6)%), and angina (63.8 (+/-0.5)%). Physicians use CCBs as initial therapy for 24.8 (+/-0.3)% of mildly and 33.1 (+/-0.3)% of moderately hypertensive patients, and add CCBs to the regimens of 39.0 (+/-0.3)% of moderately hypertensive patients not controlled on other antihypertensive therapy. In multiple regression analysis, the proportion of hypertensive patients treated with CCBs was significantly elevated among geriatricians and physicians who believe severity of hypertension is an indication for their use. CONCLUSION: These findings suggest that CCBs are used selectively for high-risk hypertensive patients. Copyright (c) 2000 John Wiley & Sons, Ltd.
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Huse et al. (2000) conducted a cross-sectional in Hypertension (n=1,023). Calcium channel blockers (CCB) was evaluated on Physician reported use of calcium channel blockers in various clinical scenarios. Calcium channel blockers are used selectively for high-risk hypertensive patients, with physician use increasing from 36.3% in mild hypertension to 63.8% in patients with angina.
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