Posted by William C Biggs MD

In Reply to: Calcium Channel Blocker Danger! ... NIDDMs and hypertension posted by ottercritr

Before everybody stops their calcium channel blockers abruptly, which will
cause even more problems, I would like to point out a few features of this
article.

This study compared the calcium channel blcoker Sular to the ACE inhibitor
Vasotec.

Sular is a dihydro pyridine type of calcium channel blocker, similar to
nifedipine (Procardia/Adalat). The mechanism by which these drugs increase
heart risk is thought to be stimulation of the sympathetic nervous system.

There are other classes of calcium channel blockers. For instance, there
does not appear to be evidence of increased risks with diltiazem or
verapamil.

Furthermore, long acting preparations of nifedipine (Procardia XL) do not
seem to cause as much sympathetic stimulation, and thus may not have the
same deleterious effect.

I would recommend that anyone reading this NEJM article also read the
accompanying editorial comment by Jeffrey Cutler MD at the National Heart
Lung and Blood Institute.

"Clearer conclusions about the choice of blood-pressure lowering drugs and
their balances of risks and benefits, for patients with diabetes as well as
other groups of patients, will have to await the results of the current
generation of randomized trials, of which there are nearly three dozen."

Please ask your doctor before you act on your own.

William C Biggs MD

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