Archief Roodbont

Calcium channel blockers linked to increased heart failure risk

16 July 2010

MedWire News: Calcium channel blockers (CCBs) may increase the risk for heart failure (HF) among patients with hypertension, Canadian researchers report.

“This effect is also observed when comparing CCBs to ACE inhibitors or angiotensin receptor blockers and to beta blockers, and/or diuretics against HF,” say Marcelo Shibata (University of Alberta, Edmonton, Canada) and team.

The researchers reviewed 19 trials with a total of 156,766 patients (mean age 54–76 years) with hypertension who were randomly assigned to receive CCB therapy (verapamil, diltiazem, or a dihydropyridine; n=69,391) or control (ACE inhibitors, angiotensin receptor blockers, beta blockers, or diuretics; n=87,375).

The findings revealed a total of 5049 HF-related events over a follow-up period of 2 to 5 years. An 18% increase in the risk for HF diagnosis was observed among the patients who received CCB therapy, irrespective of the type of CCB used.

Among 16 trials presenting data on myocardial infarction (MI) rates (n=121,404, 3612 MIs), the risk for MI was 4% lower among the CCB groups compared with the control groups.

The team says this means that “the increase in the diagnosis of HF in patients allocated to CCBs cannot be explained by differences in incident MI.”

In subgroup analysis, a 71% higher HF risk was observed among patients with diabetes in the CCB group compared with non-diabetic patients in the CCB group.

The researchers conclude: “The treatment of hypertension with CCBs increases circulating catecholamines that could potentially be involved in the pathogenesis of HF. This information supports biologic plausibility for the effect observed in our analysis and should be tested in future trials.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Am J Cardiol 2010; 106: 228–235