Common Blood Pressure Drug May Not Be So Useful for Heart
Dec. 7, 2000 -- A new study suggests doctors should be cautious about prescribing certain medications that lower high blood pressure. An analysis of nine different studies finds that one popular class of these drugs is less effective in preventing heart-related problems and may actually increase the risk of heart attacks and heart failure.
Doctors who conducted the analysis say there is no reason for patients taking these drugs, known as calcium-channel blockers, to be overly concerned. Rather, the study is meant to reiterate to doctors that these drugs should never be given as an initial treatment, or first-line therapy, for people with high blood pressure, says Marco Pahor, MD, author of the study appearing in this week's issue of The Lancet.
His study compared results from nine different blood pressure-lowering trials involving over 27,000 people. Patients in the trials received various drugs to lower their high blood pressure including calcium-channel blockers, ACE inhibitors, diuretics and beta blockers. The last two are older medications that doctors have used for years to effectively lower blood pressure.
Compared with people who took other drugs, people who took calcium-channel blockers to lower blood pressure had a 26% higher risk of heart attack, a 25% higher risk of heart failure, and a 10% higher risk of combined major heart disease.
"Doctors should limit the use of calcium-channel blockers unless other agents are not effective in lowering blood pressure or contraindicated for the patient because of side effects," says Pahor, professor of medicine and director of the Sticht Center on Aging at Wake Forest University School of Medicine in Winston-Salem, N.C.
Another study in the same issue of the journal finds that compared with ACE inhibitors, calcium-channel blockers increase the risk of heart disease by 19% and the risk of heart failure by 18%. That study included over 26,000 people with high blood pressure.
In an editorial that accompanies both of the studies, two experts from Tulane University School of Medicine in New Orleans, say the results are consistent with what a panel of experts said three years ago. At that time, the panel recommended giving only diuretics or beta blockers for the initial treatment of high blood pressure.