y surrounding their use, much of which centers around the effect of short-acting calcium channel blockers on the heart.
"The goal of treating hypertension is to reduce clinical events, not simply to lower blood pressure. Therefore, when choosing pharmacologic therapy, one must look at all the effects produced by a given agent" (11). There have been a variety of studies using various calcium channel blockers to determine this effect on those who take them.
A group of studies have documented the potential negative effects. Psaty et al. found that the short-acting dihydropyridines could cause possible harm while the long-acting calcium channel blockers remained untested (19). Another study by Alderman et al. studied 189 patients who had had a stroke or heart attack and 189 patients who had not and found that long-acting calcium channel blockers were not associated with stroke or heart attack but that short-acting calcium channel blockers increased the risk almost four-fold (1). In the Multicenter Isradipine Diuretic Atherosclerosis Study, it was found that in patients who received calcium channel blockers, major cardiovascular events increased by 80% as compared to those who received hydrochlorothiazide (11). The Evaluation Group of Long-term Antihypertensive Treatment documented a higher risk of cerebrovascular accident with the use of dihydropyridine calcium channel blockers over the use of an ACE inhibitor (11). Paher et al. compared mortality rates among 206 elderly persons treated for hypertension and established that those taking nifedipine had a 70% greater all-cause mortality over the group taking a beta blocker (11). Furberg at al. completed a meta-analysis of randomized trials of short-acting nifedipine in patients with CAD and found the drug to be associated with 15% excess mortality compared with the placebo group (11). Dr. Furberg also noted potential harms to include proischemic, negative inotropic, proarrhyt...