Does the use of ACE inhibitors, calcium channel blockers, or diuretics compared to beta-blockers reduce the risk of fatal myocardial infarction in otherwise healthy treated hypertensive subjects?
In otherwise healthy hypertensive patients, the risk of fatal myocardial infarction did not significantly differ between users of ACE inhibitors, calcium channel blockers, or diuretics compared to beta-blocker users.
We conducted a case-control study to evaluate the risk of fatal myocardial infarction in otherwise healthy treated hypertensive subjects according to the type of the antihypertensive drug used. The study encompassed 207 cases and 409 controls matched to cases on age, sex, and general practice. Compared with beta-blocker users, the matched relative risk estimates for fatal myocardial infarction, adjusted for recent blood pressure, body mass index, smoking, duration of hypertension, and prior use of other antihypertensive drugs, were 0.7 95% confidence interval (CI) = 0.4-1.2 for angiotensin-converting enzyme inhibitor users, 0.9 (95% CI = 0.5-1.5) for calcium channel blocker users, and 0.7 (95% CI = 0.4-1.2) for diuretic users.
Jick et al. (Tue,) studied this question.