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Cardiac Drug Therapy pp 81–83Cite as

Calcium Antagonist Controversies

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Part of the book series: Contemporary Cardiology ((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).

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References

  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.

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  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.

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  3. CONVINCE: Black HR, Elliott WJ, Grandits G, et al. for the CONVINCE Research Group. JAMA 2003; 289:2073–2082.

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  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.

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  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.

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  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.

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© 2007 Humana Press Inc., Totowa, NJ

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(2007). Calcium Antagonist Controversies. In: Cardiac Drug Therapy. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-59745-238-0_6

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  • DOI: https://doi.org/10.1007/978-1-59745-238-0_6

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-904-8

  • Online ISBN: 978-1-59745-238-0

  • eBook Packages: MedicineMedicine (R0)

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