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Morbidity and mortality with dihydropyridines
1Department of Geriatrics, Clinical Hypertension Research, University of Uppsala, Sweden.
Blood Pressure. Supplement
|July 11, 1998
Summary
Dihydropyridine calcium antagonists effectively lower blood pressure and reduce cardiovascular disease. Long-term trials confirm their benefit in hypertension treatment, refuting earlier safety concerns.
Area of Science:
- Cardiology
- Pharmacology
- Hypertension Management
Background:
- Dihydropyridine calcium antagonists (CaAs) are widely prescribed for hypertension.
- Their efficacy in lowering blood pressure and tolerability are well-established.
- Emerging trial data investigate their impact on cardiovascular morbidity.
Purpose of the Study:
- To review the evidence for the cardiovascular benefits of dihydropyridine CaAs in hypertension.
- To address concerns regarding potential adverse effects on morbidity and mortality.
- To compare CaA-based therapy with conventional treatments.
Main Methods:
- Review of data from landmark intervention trials, including STONE and Syst-Eur.
- Inclusion of ongoing studies like HOT and STOP-2.
- Consideration of analyses by the World Health Organization and International Society of Hypertension.
Main Results:
- Trials like Syst-Eur demonstrated significant cardiovascular disease prevention with CaA treatment.
- Ongoing studies suggest a positive effect on cardiovascular morbidity.
- Expert reviews have refuted claims of increased morbidity and mortality associated with CaAs.
Conclusions:
- Available evidence supports a beneficial effect of dihydropyridine CaAs on cardiovascular morbidity in hypertensive patients.
- Further results from STOP-2 will clarify if CaA benefits exceed those of diuretics or beta-blockers.