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Calcium Channel Blockers and Myocardial Infarction: Title and subTitle BreakA Hypothesis Formulated but Not Yet Tested FREE

Julie E. Buring, ScD; Robert J. Glynn, ScD; Charles H. Hennekens, MD, DrPH
[+] Author Affiliations

Reprint requests to Division of Preventive Medicine, 900 Commonwealth Ave E, Boston, MA 02215 (Dr Buring).


JAMA. 1995;274(8):654-655. doi:10.1001/jama.1995.03530080070044
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In this week's JAMA, Psaty and colleagues1 present 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

REFERENCES

Psaty BM, Heckbert SR, Koepsell TD, et al.  The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA . 1995;;274:620-625.
Lenfant C.  The calcium channel blocker scare: lessons for the future. Circulation . 1995;;91:2855-2856.
Hennekens CH, Buring JE. Epidemiology in Medicine . Boston, Mass: Little Brown & Co; 1987;.
Hebert PR, Fiebach NH, Eberlein KA, et al.  The community-based randomized trials of pharmacologic treatment of mild-to-moderate hypertension. Am J Epidemiol . 1988;;127:581-590.
Collins R, Peto R, MacMahon S, et al.  Blood pressure, stroke, and coronary heart disease. Lancet . 1990;;335:827-838.
Monane M, Glynn RJ, Gurwitz JH, et al.  Trends in medication choices for hypertension in the elderly: the decline of the thiazides. Hypertension . 1995;;25:1045-1051.
Hennekens CH, Buring JE.  Observational evidence. Ann N Y Acad Sci . 1993;;703:18-24.
Hebert PR, Moser M, Mayer J, Glynn RJ, Hennekens CH.  Recent evidence on drug therapy of mild to moderate hypertension and decreased risk of coronary heart disease. Arch Intern Med . 1993;;153:578-581.
Members of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure.  The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-V). Arch Intern Med . 1993;;153:154-183.

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Psaty BM, Heckbert SR, Koepsell TD, et al.  The risk of myocardial infarction associated with antihypertensive drug therapies. JAMA . 1995;;274:620-625.
Lenfant C.  The calcium channel blocker scare: lessons for the future. Circulation . 1995;;91:2855-2856.
Hennekens CH, Buring JE. Epidemiology in Medicine . Boston, Mass: Little Brown & Co; 1987;.
Hebert PR, Fiebach NH, Eberlein KA, et al.  The community-based randomized trials of pharmacologic treatment of mild-to-moderate hypertension. Am J Epidemiol . 1988;;127:581-590.
Collins R, Peto R, MacMahon S, et al.  Blood pressure, stroke, and coronary heart disease. Lancet . 1990;;335:827-838.
Monane M, Glynn RJ, Gurwitz JH, et al.  Trends in medication choices for hypertension in the elderly: the decline of the thiazides. Hypertension . 1995;;25:1045-1051.
Hennekens CH, Buring JE.  Observational evidence. Ann N Y Acad Sci . 1993;;703:18-24.
Hebert PR, Moser M, Mayer J, Glynn RJ, Hennekens CH.  Recent evidence on drug therapy of mild to moderate hypertension and decreased risk of coronary heart disease. Arch Intern Med . 1993;;153:578-581.
Members of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure.  The fifth report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC-V). Arch Intern Med . 1993;;153:154-183.
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