inklap

The Calcium Channel Blocker Controversy in Perspective

Alberto Zanchetti · Cardiology · 2008

Periodically in the history of hypertensive therapy there have been minor storms that have significantly affected the utilization of entire classes of agents. The first storm struck with the case-control studies suggesting that reserpine was associated with an increased risk of carcinoma of the breast, a claim subsequently disproved by a number of other studies. The second storm was initiated by a subanalysis of the Multiple Risk Factor Intervention Trial (MRFIT), from which it was inferred that, in a subset of hypertensive patients, diuretic treatment may have been harmful rather than beneficial. Despite this claim and other speculations, diuretics - especially at low doses - remain a gold standard of antihypertensive therapy. Recently, a third storm has developed in the field of antihypertensive therapy: a case-control study report and a non-randomized cohort study have questioned the use of calcium channel blockers in hypertension. The case-control study suffers from the limitations inherent in this study design, which often gives rise to conflicts and contradiction. In fact, another case-control study published in 1995 reached exactly the opposite conclusions and claimed that c

📖 افتح في inklap 🔗 DOI 📮 اطلب بحثاً