Advertisement

Calcium Antagonist Controversies

Part of the Contemporary Cardiology book series (CONCARD)

Abstract

Calcium antagonists without doubt cause an increased incidence of heart failure (HF) as observed in several well-run randomized controlled trials (RCTs):
  • Amlodipine in Antihypertensive and Lipid-Lowering Treatment (ALLHAT): HF 38% versus diuretic (1).

  • Nifedipine in Intervention as a Goal in Hypertension Treatment (INSIGHT): HF 46% versus diuretic (2).

  • Verapamilin Controlled Onset Verapamil Investigation of Cardiovascular EndPoints (CONVINCE): HF 30% (3).

  • Amlodipine in Prospective Randomized Amlodipine Survival Evaluation (PRAISE) caused significant increased pulmonary edema in patients with left ventricular (LV) dysfunction (4).

  • Diltiazem caused a significant increase in HF in a non-Q-wave infarction study (5).

Keywords

Calcium Antagonist Sick Sinus Syndrome Verapamil Sustained Release Hydrochlorothiazide Group Prior Heart Failure 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major out-comes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs. diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA 2002;288:2981–2997.CrossRefGoogle Scholar
  2. 2.
    Brown MJ, Palmer CR, Castaigne A, et al. Morbidity and mortality in patients randomised to double-blind treatment with a long-acting calcium-channel blocker or diuretic in the International Nifedipine GITS study: Intervention as a Goal in Hypertension Treatment. Lancet 2000;356:366–372.PubMedCrossRefGoogle Scholar
  3. 3.
    CONVINCE: Black HR, Elliott WJ, Grandits G, et al. for the CONVINCE Research Group. JAMA 2003; 289:2073–2082.PubMedCrossRefGoogle Scholar
  4. 4.
    Packer M, O’Connor CM, Ghali JK, et al. Effect of amlodipine on morbidity and mortality in severe chronic heart failure: For the Prospective Randomised Amlodipine Survival Evaluation Study Group. N Engl J Med 1996;335:1107.PubMedCrossRefGoogle Scholar
  5. 5.
    Multicenter Diltiazem Postinfarction Trial Research Group. The effect of diltiazem on mortality and reinfarction after myocardial infarction. N Engl J Med 1989;319:385.Google Scholar
  6. 6.
    INVEST: Pepine CJ, Handberg EM, Rhonda M, et al. for the INVEST Investigators. A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): A randomized controlled trial. JAMA 2003;290: 2805–2816.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc., Totowa, NJ 2007

Personalised recommendations