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Calcium channel blockers and myocardial infarction: a case--control study in a Japanese hospital

Yoshiharu Ohyama1, Kazuhiro Funao, Eri Kawabe

  • 1Department of Clinical Pharmacy, Tokyo University of Pharmacy and Life Science, Hachioji, Tokyo 192-0392, Japan.

Pharmacoepidemiology and Drug Safety
|November 13, 2002
PubMed

Insights

Calcium channel blockers (CCBs) use in hypertensive patients showed a high association with myocardial infarction in Japan. However, this link weakened after adjusting for confounding factors, suggesting indication bias.

Area of Science:

  • Cardiology
  • Pharmacology
  • Epidemiology

Background:

  • Calcium channel blockers (CCBs) are frequently prescribed for hypertension in Japan.
  • The relationship between CCB use and myocardial infarction (MI) requires investigation, especially in populations with high CCB prescription rates.

Purpose of the Study:

  • To investigate the association between calcium channel blocker (CCB) use and myocardial infarction (MI) in hypertensive patients in Japan.
  • To explore potential confounding factors influencing this relationship.

Main Methods:

  • A nested case-control study was conducted using a Japanese hospital information system.
  • Cases were hypertensive patients with MI (fatal or non-fatal) between 1996-1999.
  • Controls were individually matched hypertensive patients without MI.

Main Results:

  • The study included 16 cases and 80 matched controls.
  • A high proportion of controls (68%) and nearly all cases (15/16) used CCBs.
  • The crude odds ratio for MI associated with CCB use was 7.0, reducing to 4.9 after adjustment for diabetes and diastolic blood pressure.

Conclusions:

  • The observed association between CCB use and MI may be influenced by confounding by indication.
  • Results from this single-center study should be interpreted with caution and not generalized.
Abstract

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