Use of calcium channel blockers as antihypertensives in relation to mortality and cancer incidence: a population-based observational study.
OBJECTIVE
Treatment with blood pressure lowering drugs may reduce morbidity and mortality. However, the efficacy and effectiveness may differ between antihypertensive agents. The current investigation aimed to compare mortality and cancer incidence in hypertensive patients treated with calcium channel blockers (CCB) or with other antihypertensive drugs (AHD).


METHODS
All patients in two outpatient clinics treated with AHD who underwent an annual check-up during 1989 or 1990 were selected. Fatal events were identified through 1997 and incident cancers through 1998.


RESULTS
Two hundred and fourteen patients on CCB and 1029 on other AHD were identified. Overall mortality and the combined mortality from myocardial infarction and stroke were higher in CCB users; hazard ratios adjusted for sex, age, comorbidity and other and risk factors were 1.84 (95% CI 1.25-2.72) and 2.37 (95% CI 1.27-4.44), respectively. The risk estimates for cancer mortality and for cancer incidence did not differ significantly.


CONCLUSIONS
Results from clinical trials as well as observational studies, including the present one, indicate a higher mortality risk and a higher cardiovascular morbidity risk associated with use of CCB. Accordingly, CCB should not be regarded as first line drugs in hypertension.
Lindberg
Gunnar
G
NEPI Foundation, Medical Research Centre, Malmö University Hospital, SE-205 02 Malmö, Sweden. gunnar.lindberg@nepi.net
Lindblad
Ulf
U
Löw-Larsen
Bent
B
Merlo
Juan
J
Melander
Arne
A
Råstam
Lennart
L
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000453:epidemiology / Q000401:mortality; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000139:chemically induced / Q000453:epidemiology; D009369:Neoplasms / Q000139:chemically induced* / Q000453:epidemiology; D012907:Smoking; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers