CALCIUM-CHANNEL BLOCKERS - ASSOCIATION WITH MYOCARDIAL-INFARCTION, MORTALITY, AND CANCER

The purpose of this study was to review the results of trials assessin g the association between the use of calcium channel blockers (CCBs) a nd mortality, myocardial infarction (MI), and cancer. Possible mechani sms of such relationships are discussed and recommendations regarding the use of CCBs made. Since 1995, 10 controversial studies have been p ublished that associate the use of CCBs with an increased risk of mort ality, MI, and cancer; these findings have caused widespread anxiety a nd frustration among patients and physicians. For health care professi onals to properly advise patients, the facts surrounding this controve rsy should be reviewed. To do this, we reviewed and assessed English-l anguage clinical studies, abstracts, editorials, and review articles p ertaining to the use of CCBs and mortality. MI, and cancer in humans. The designs of ongoing prospective, randomized studies are discussed. Based on current published studies, the US Food and Drug Administratio n has agreed to a label warning against off-label use of short-acting nifedipine in patients with hypertension, acute MI, or nonvasospastic unstable angina. Practitioners should exercise caution when prescribin g CCBs, especially to high-risk patients (eg, those with congestive he art failure or clinical or subclinical coronary artery disease). When possible, long-acting CCBs should be used.