Role of calcium channel blockers in the future, in view of the INSIGHT Study.
The data from The International Nifedipine Intervention as a Goal in Hypertension Treatment (INSIGHT) Study indicate that effectively reducing blood pressure can decrease the incidence of cardiovascular events in high risk patients with concomitant pathology, including diabetes and hypercholesterolemia, as well as in smokers and those with poor family history. Old and new antihypertensive drugs were similar in preventing cardiovascular mortality as major events. The glomerular filtration rate of patients on co-amilozide went down compared to those on nifedipine. Metabolic parameters, as expected, were not disturbed during treatment with calcium channel blockers, in contrast to the high-dose diuretic-treated population. Ankle edema induced by nifedipine was very disturbing. It can be concluded that overall calcium channel blockers are neither better nor worse than conventional therapy, allowing for possible small differences in stroke (advantage to calcium channel blockers) and myocardial infarction (advantage to diuretics). Thus, calcium channel blockers should be included in the future among the first choice drugs.
Rosenthal
Talma
T
Chorley Hypertension Research Institute, Chaim Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine,Tel Aviv University, Tel Aviv, Israel. trosenth@sheba.health.gov.il
D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D002121:Calcium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D009543:Nifedipine / Q000627:therapeutic use*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D013997:Time Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D009543:Nifedipine