Clinical implications of the World Health Organization-International Society of Hypertension statement on calcium antagonists.
The controversy over the efficacy and safety of calcium antagonists is over 2 years old. Since millions of patients worldwide are currently using calcium antagonists for the treatment of high blood pressure and angina, a systematic review of their potential risks and benefits is much needed. In response to this need, the World Health Organization (WHO) and the International Society of Hypertension (ISH) recently convened an ad-hoc subcommittee to review the available evidence (J Hypertens 1997, 15:105-115). Importantly, the WHO-ISH statement does take a strong stand in favor of large long-term trials that compare antihypertensive agents, and we all agree that these comparative trials are urgently needed. However, the WHO-ISH statement is marred in part by errors of omission, by the selective use of evidence and epidemiologic principles, and by a narrow application of the viewpoint of those who believe that evidence can come only from the results of megatrials. As a result, practicing clinicians will find more useful information in existing hypertension and postmyocardial infarction guidelines (Arch Intern Med 1993, 153:154-183 and JAm Coll Cardiol 1996, 28:1328-1428).
Psaty
B M
BM
The Department of Medicine, University of Washington, Seattle 98101, USA.
Furberg
C D
CD
D002121:Calcium Channel Blockers / Q000009:adverse effects*; D003327:Coronary Disease / Q000139:chemically induced*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D014944:World Health Organization
D002121:Calcium Channel Blockers