Question re: CCBs & beta blockers

[Lenin]

I have never heard that ccb's can cause heart attacks.

The evidence is there. It's a result of a couple studies in the mid '90's. A couple studies had to be actua;;py STOPPED becasue of the high incidence of heart attacks.

This is not the first time that concerns have been raised over the safety of calcium channel blockers. In 1995 a study found that short acting calcium channel blockers such as nifedipine were associated with an increased risk of heart attack (JAMA 1995;274:620-5). This effect was thought to be limited to the short acting dihydropyridine subtypes, and the new study is the first to suggest that long acting calcium channel blockers may share this cardiovascular risk. Calcium channel blockers have also been recently associated with increased risks of suicide and depression, gastrointestinal haemorrhage, and even cancer. The MIDAS study (JAMA 1995;274:620-5) also found more adverse cardiovascular events such as angina and stroke in patients given calcium channel blockers compared with those taking diuretics.

These drugs are NOT innocuous.

FDA:

Data suggesting that certain patients with high blood
pressure who were given immediate-release formulations of certain
calcium channel blockers (nifedipine, diltiazem and verapamil) were more likely to suffer heart attacks than patients who received
other medications, such as diuretics or beta-blockers.

[cartner]

Lenin,

it says

Data suggesting that certain patients with high blood
pressure who were given "immediate-release formulations" of certain
calcium channel blockers (nifedipine, diltiazem and verapamil) were more likely to suffer heart attacks than patients who received
other medications.

So they are not talking about the SR ones?
Thanks for help,
Michael

[Lenin]

Mike,

THe data seems to support the longer acting versions to be less harmful than the fast acting ones but nobody is giving the long acting ones a clean bill of health.
Nifedipine seems to be the largest offender with stroke and heart attack rates almost 30% higher than placebo...IMAGINE!
With ANY CCB, be wary.

Problem is the studies. We take hypertension and anti angina medicine to prevent DEATH and DISABILITY. But the only TEST of these drugs is whether they lower systolic blood pressure or casue less chest pain...long term effects are ignored and FINDING them is actively discouraged.

This HAS to change.

A good way to deal with the problem is NEVER to take a drug that isn't 10, or better yet 20 years old...and even then, read everything you can about it.

I guess the CCB drug being pushed the hardest these days is Norvasc (amlodipine.) I wonder what it's long term expectations are?

[cartner]

Thanks Lenin , I guess that Diltiazem is more than 20 years old right?
I really have no other option, this is the only drug that works for me.
Michael

[lane413]

Lenin, thank you sooooo much. My mom has been complaining about verapamil sr (generic) and her doctor refuse to change the drug. She was more concern about the breast cancer connection, we didn't even know about the heart attack part.

The sad part about it is that the verapamil and clonidine do not lower her bp very much. She can't take avapro or lisinopril so what else is there. I guess we're keep trying. Thank you.