Case-Control Study, Meta-analysis, and Bouillabaisse: Putting the Calcium Antagonist Scare into Context

Editorials1 December 1995Case-Control Study, Meta-analysis, and Bouillabaisse: Putting the Calcium Antagonist Scare into ContextFranz H. Messerli, MDFranz H. Messerli, MDOchsner Clinic and Alton Ochsner Medical Foundation New Orleans, LA 70121Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-11-199512010-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The recent panic over the use of calcium antagonists in cardiovascular medicine stems from two sources: 1) a presentation of a case–control study at the 35th Annual Conference on Cardiovascular Disease, Epidemiology, and Prevention on 10 March 1995, in San Antonio, Texas, and 2) a meta-analysis purporting to show a dose-related increase in mortality in patients with coronary heart disease who receive treatment with nifedipine, which was presented to the scientific community all over the globe. Unfortunately, numerous inflammatory articles were printed by the lay press, creating much of anxiety among patients—some of whom stopped taking their medications. Physicians were ...References1. “Drugs for blood pressure linked to heart attack. Researchers feel 6 million are imperiled. Washington Post. 1995 Mar 11; sect 8 (col 1).” Google Scholar2. Byrd J. Scared readers Ombudsman. Washington Post. 1995 Mar 26; sect 6 (col 5). Google Scholar3. Psaty BM, Heckbert SR, Koepsell TD, Siscovick DS, Raghunathan TE, Weiss NS, et al. The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA. 1995; 274:620-5. Google Scholar4. Furberg CD, Psaty BM, Meyer JV. Nifedipine. Dose-related increase in mortality in patients with coronary heart disease. Circulation. 1995; 92:1326-31. Google Scholar5. Buring JE, Glynn RJ, Hennekens CH. Calcium channel blockers and myocardial infarction: a hypothesis formulated but not yet tested Editorial. JAMA. 1995; 274:654-5. Google Scholar6. Opie LH, Messerli FH. Nifedipine and mortality: grave defects in the dossier Editorial. Circulation. 1995; 92:1068-73. Google Scholar7. Kloner RA. Nifedipine in ischemic heart disease Editorial. Circulation. 1995; 92:1074-8. Google Scholar8. Yusuf S. Calcium antagonists in coronary artery disease and hypertension. Time for reevaluation? Editorial. Circulation. 1995; 92:1079-82. Google Scholar9. Messerli FH. Cardioprotection—not all calcium antagonists are created equal Editorial. Am J Cardiol. 1990; 66:855-6. Google Scholar10. Held PH, Yusuf S, Furberg CD. Calcium channel blockers in acute myocardial infarction and unstable angina: An overview. BMJ. 1989; 299:1187-92. Google Scholar11. Lichtlen PR, Hugenholtz PG, Rafflenbeul W, Hecker H, Jost S, Deckers JW. Retardation of angiographic progression of coronary artery disease by nifedipine. Results of the International Nifedipine Trial on Antiatherosclerotic Therapy (INTACT). INTACT Group Investigators see comments. Lancet. 1990; 335:1109-13. Google Scholar12. Gonser M, Vetter K, Noack F. Meta-analyses of interventional trials done in populations with different risks Letter. Lancet. 1995; 345:1304. Google Scholar13. Yusuf S, Held P, Furberg C. Update of effects of calcium antagonists in myocardial infarction or angina in light of the second Danish Verapamil Infarction Trial (DAVIT-II) and other recent studies Editorial. Am J Cardiol. 1991; 67:1295-7. Google Scholar14. Mitchell AB. MRC trial of treating hypertension in older adults. BMJ. 1992; 304:405-12. Google Scholar Author, Article, and Disclosure InformationAffiliations: Ochsner Clinic and Alton Ochsner Medical Foundation New Orleans, LA 70121Corresponding Author: Franz H. Messerli, MD, Ochsner Clinic, 1514 Jefferson Highway, New Orleans, LA 70121. 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