Do CCBs cause heart attacks?

[Sonia567]

Hi everyone,

I remember reading on this board, someone referring to recent studies that CCB's have been linked to an increased risk for heart attacks, especially in women. Does anyone have more information on this?

Of course, now my dr. wants me to take a CCB, and he seems to think I am being paranoid when I told him about my concern about the recent studies. He said that it is not true; that it used to be a concern (years ago), but now that you can take a dose once a day, that they are thought not to cause that anymore. (and I thought the studies were recent?)

Any input is greatly appreciated.
Sonia

[flowergirl2day]

CCB's have been linked to an increased risk for heart attacks, especially in women.

Hi Sonia,

First of all, CCBs should be considered first-line antihypertensive medication because of they are effective and have mild and reversible side effects. They can be used as a stand alone treatment or in combination with diuretics. If you start out with CCBs, you might not need any diuretics (which have more serious side effects in some people).

....The drug in question, short-acting nifedipine, should be used with great caution or NOT AT ALL, especially in high doses,... -warned the Heart, Lung and Blood Institute back then. (I believe the doctors don't prescribe it anymore.)

There were smaller clinical trials and several studies done, the results of which, as we hear now, were not intererpreted with the right perspective.

You can find and read the original published studies and the comments and follow-ups published afterwards. A good place to start would be JAMA and circulation AHA journals and an Archive of Internal Medicine.

Importantly: The nifedipine finding cannot be necessarily generalized to any other CCB including longer acting forms of nifedipine and short acting formulas of diltiazem and verapamil....
So it was probably just that one specific drug whose suitability was being questioned.

This drug was also linked to higher frequency of cancer and found unsuitable for use in people with HF and structural heart problems. I don't know how long ago this was and did not read the studies. Don't quote me on it. In any case, I think the short acting version is not produced commercially anymore.

Good luck with your treatment, Sonia!


Flowergirl

[Lenin]

Sonia,

Try this to check out your doctor's integrity: Tell him, "YES you'll try ANY CCB except for NORVASC."
If he seems to lose interest in the subject entirely you'll know that you have a doctor who is only interested in pushing drugs that enrich him. Exactly that happened to me when my doctor started hinting at calcium channel blockers. (I had tried Norvasc for a month from my cardiologist and KNEW that I hated it.)

Personally, I would go out of my way to avoid CCB's for just hypertension. In NO SENSE are they considered the "first-line" antihypertensives. That singular honor STILL rests with cheap old diuretics, much to the chagrin of Pfizer.

YES,
These drugs increase the risk of heart attack and YES nifedipine is the worst of the worst. And alas, NORVASC was the most widely prescribed antihypertensive and third among all drugs until the month it went off patent when sales came crashing down...now doctors don't think quite so much of it as before...I guess their remuneration has been cut, poor dears!

[bethsheba]

Originally Posted by Lenin

... In NO SENSE are they considered the "first-line" antihypertensives. That singular honor STILL rests with cheap old diuretics, much to the chagrin of Pfizer.

Lenin,

Your comment may be misleading to those who are not familiar with the government's algorithm for the treatment of hypertension which advises doctors to prescribe their initial drug choices based on a patient's medical history and based on their stage of hypertension. Someone diagnosed with pre hypertention may have different first line medication than someone diagnosed with stage 1 or stage 2 hypertension. Someone with compelling indications such as heart failure, post myocardial infarction, high CVD risk, diabetes, chronic kidney disease, or recurrent stroke prevention may have different guidelines than someone without compelling indications. In other words, "first-line" antihyperintensives are based on individual circumstances and are not necessarily diuretics!

NORVASC was the most widely prescribed antihypertensive and third among all drugs until the month it went off patent when sales came crashing down...

After being on hydrochlorothiazide, lisinopril, benicar hctz, and atenolol, and experiencing memory loss, cognitive problems, sleep disturbances and disorders, mood problems, exhaustion, elevated cholesterol levels, gout, muscle, joint, and bone pain, weight gain, increased blood pressure, and suicidal ideations--- norvasc ( with side effects of facial flushing and 1-2 nocturnal awakenings per night) was a godsend to me.

Yes, I'm sure the sales came crashing down when the patent expired, but like me, I'm sure many patients simply switched to the generic form.

Bsheba

[bethsheba]

Originally Posted by flowergirl2day

Hi Sonia,

First of all, CCBs should be considered first-line antihypertensive medication because of they are effective and have mild and reversible side effects. They can be used as a stand alone treatment or in combination with diuretics. If you start out with CCBs, you might not need any diuretics (which have more serious side effects in some people)....

Flowergirl

I appreciate your comment...especially about it being effective and having mild and reversible side effects. Although diuretics are the first line of med for many with hypertension, the side effects can be very serious indeed.

Bsheba