Diuretics are preferred first-line over CCBs to optimize reduction of cardiovascular events .
The review does not distinguish between CCBs , ACE inhibitors or ARBs , but does provide evidence supporting the use of CCBs over beta-blockers .
BACKGROUND Calcium channel blockers ( CCBs ) are a relatively new antihypertensive class .
The effect of first-line CCBs on the prevention of cardiovascular events , as compared with other antihypertensive drug classes , is unknown .
OBJECTIVES To determine whether CCBs used as first-line therapy for hypertension are different from other first-line drug classes in reducing the incidence of major adverse cardiovascular events .
Calcium antagonists and mortality risk in men and women with hypertension in the Framingham Heart Study.
BACKGROUND Several recent studies have suggested that calcium antagonist drugs , which are widely used for the treatment of hypertension , are associated with increased risk of cardiovascular disease . These studies have cast doubts on the long-term safety of calcium antagonists . OBJECTIVE To examine the association of calcium antagonist use with mortality in subjects with hypertension followed up in the Framingham Heart Study . SUBJECTS AND METHODS We stratified 3539 subjects ( mean+/-SD age , 64+/-13 years ) from the Framingham Heart Study who had hypertension at routine clinic examinations , according to the use of calcium antagonists and presence of coronary heart disease at the baseline examination . At each follow-up examination ( every 2 - 4 years ) , subjects were reclassified with regard to the use of calcium antagonists . The end point of the study was all-cause mortality . Hazard ratios and 95 % confidence intervals associated with the use of calcium antagonists were obtained using Cox proportional hazards regression models . RESULTS There were 970 deaths during follow-up . Hazard ratios for mortality associated with the use of calcium antagonists were 0.93 ( 95 % confidence interval , 0.72 - 1.21 ; P=.59 ) for subjects with hypertension without coronary heart disease , and 0.92 ( 95 % confidence interval , 0.69 - 1.24 ; P=.58 ) for those with coronary heart disease at baseline . All models were adjusted for age , sex , current smoking , systolic and diastolic blood pressure , use of beta-blockers , and use of other antihypertensive medications . CONCLUSIONS In this cohort of 3539 subjects with hypertension there were no differences in mortality among subjects with hypertension using a calcium antagonist compared with those who were not . Results were similar among subjects with hypertension with and without coronary heart disease . The results of ongoing long-term , r and omized clinical trials will provide more definitive data on the safety of calcium antagonists
Diuretics are preferred first-line over CCBs to optimize reduction of cardiovascular events .
The review does not distinguish between CCBs , ACE inhibitors or ARBs , but does provide evidence supporting the use of CCBs over beta-blockers .
BACKGROUND Calcium channel blockers ( CCBs ) are a relatively new antihypertensive class .
The effect of first-line CCBs on the prevention of cardiovascular events , as compared with other antihypertensive drug classes , is unknown .
OBJECTIVES To determine whether CCBs used as first-line therapy for hypertension are different from other first-line drug classes in reducing the incidence of major adverse cardiovascular events .